| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
347 |
347 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
456 |
403 |
$3K |
| 92551 |
|
827 |
827 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
290 |
290 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,050 |
3,682 |
$2K |
| 99173 |
|
846 |
846 |
$384.84 |
| 90686 |
|
777 |
776 |
$270.01 |
| 90734 |
|
78 |
78 |
$120.96 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,085 |
1,066 |
$69.06 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$35.01 |
| 90688 |
|
154 |
154 |
$22.08 |
| 92552 |
|
48 |
48 |
$10.41 |
| 90674 |
|
85 |
85 |
$0.00 |
| 1000F |
|
60 |
60 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
126 |
126 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
54 |
53 |
$0.00 |
| 3074F |
|
53 |
53 |
$0.00 |
| 3008F |
|
83 |
83 |
$0.00 |
| 90651 |
|
25 |
25 |
$0.00 |
| 97802 |
|
115 |
115 |
$0.00 |
| 99443 |
|
157 |
149 |
$0.00 |
| 90620 |
|
16 |
16 |
$0.00 |
| 3078F |
|
53 |
53 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
64 |
64 |
$0.00 |
| 99401 |
|
79 |
79 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
92 |
90 |
$0.00 |
| G0270 |
Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes |
80 |
80 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
29 |
29 |
$0.00 |
| 3725F |
|
269 |
264 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 90621 |
|
26 |
25 |
$0.00 |
| 99442 |
|
93 |
89 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$0.00 |