| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92551 |
|
566 |
565 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,373 |
4,152 |
$2K |
| 92552 |
|
194 |
191 |
$809.52 |
| 97802 |
|
2,893 |
2,890 |
$631.05 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
588 |
573 |
$579.27 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
114 |
113 |
$549.44 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,175 |
1,173 |
$347.28 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
268 |
268 |
$311.85 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
947 |
945 |
$296.16 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
432 |
430 |
$247.16 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
649 |
649 |
$108.56 |
| 81002 |
|
3,066 |
3,045 |
$36.21 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
442 |
442 |
$31.08 |
| 99173 |
|
726 |
719 |
$6.93 |
| 85018 |
|
605 |
602 |
$4.10 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,088 |
1,066 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
26 |
26 |
$0.00 |
| 90633 |
|
45 |
43 |
$0.00 |
| 90710 |
|
59 |
59 |
$0.00 |
| 90685 |
|
15 |
15 |
$0.00 |
| 81003 |
|
13 |
13 |
$0.00 |
| 90670 |
|
29 |
29 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$0.00 |
| 1220F |
|
486 |
486 |
$0.00 |
| 3008F |
|
1,090 |
1,090 |
$0.00 |
| 3352F |
|
197 |
197 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
154 |
151 |
$0.00 |
| 86580 |
|
12 |
12 |
$0.00 |
| 90686 |
|
39 |
38 |
$0.00 |
| 90651 |
|
13 |
12 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
27 |
27 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 90698 |
|
13 |
13 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
25 |
25 |
$0.00 |