| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
245 |
227 |
$18K |
| 96127 |
|
265 |
247 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
40 |
40 |
$891.02 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
140 |
130 |
$631.80 |
| 96160 |
|
274 |
255 |
$278.09 |
| 90686 |
|
16 |
16 |
$117.49 |
| H0049 |
Alcohol and/or drug screening |
36 |
36 |
$76.62 |
| 36415 |
Collection of venous blood by venipuncture |
220 |
212 |
$57.94 |
| 99173 |
|
31 |
31 |
$28.35 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
177 |
161 |
$5.71 |
| 1000F |
|
49 |
49 |
$0.00 |
| 4293F |
|
49 |
49 |
$0.00 |
| 1220F |
|
56 |
56 |
$0.00 |
| 99072 |
|
255 |
230 |
$0.00 |
| 3725F |
|
47 |
47 |
$0.00 |
| 99408 |
|
12 |
12 |
$0.00 |