| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
169 |
156 |
$3K |
| 92551 |
|
578 |
578 |
$1K |
| 90686 |
|
609 |
603 |
$459.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
155 |
153 |
$155.62 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
168 |
167 |
$89.20 |
| 92015 |
Determination of refractive state |
613 |
613 |
$42.58 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
219 |
219 |
$10.00 |
| 90672 |
|
16 |
16 |
$8.91 |
| S9451 |
Exercise classes, non-physician provider, per session |
373 |
372 |
$0.00 |
| 3008F |
|
390 |
390 |
$0.00 |
| 90651 |
|
37 |
37 |
$0.00 |
| 90688 |
|
32 |
32 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
50 |
50 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
19 |
13 |
$0.00 |
| 3074F |
|
25 |
25 |
$0.00 |
| 3078F |
|
25 |
25 |
$0.00 |
| 90685 |
|
26 |
26 |
$0.00 |
| 97803 |
|
431 |
430 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
64 |
64 |
$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 |
173 |
173 |
$0.00 |
| 90670 |
|
27 |
25 |
$0.00 |
| 90700 |
|
29 |
29 |
$0.00 |