| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
708 |
706 |
$21K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
884 |
883 |
$20K |
| 92552 |
|
2,625 |
2,624 |
$17K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
533 |
533 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
943 |
702 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,154 |
2,099 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,620 |
1,548 |
$2K |
| 99173 |
|
2,001 |
1,999 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
203 |
201 |
$1K |
| 97802 |
|
1,460 |
1,458 |
$1K |
| 90688 |
|
525 |
525 |
$1K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
320 |
306 |
$825.71 |
| 90651 |
|
202 |
202 |
$752.02 |
| 92081 |
|
396 |
394 |
$198.60 |
| 90670 |
|
61 |
61 |
$198.00 |
| 90650 |
|
15 |
15 |
$135.01 |
| 90619 |
|
13 |
13 |
$108.00 |
| 90734 |
|
108 |
108 |
$108.00 |
| 90633 |
|
30 |
29 |
$81.00 |
| 90698 |
|
12 |
12 |
$72.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
371 |
371 |
$71.25 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
375 |
368 |
$61.79 |
| 90461 |
|
181 |
172 |
$40.40 |
| 90620 |
|
15 |
15 |
$36.00 |
| 90649 |
|
12 |
12 |
$9.00 |
| G8433 |
Screening for depression not completed, documented patient or medical reason |
51 |
51 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
12 |
12 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
102 |
99 |
$0.00 |
| 99401 |
|
12 |
12 |
$0.00 |
| 90621 |
|
15 |
15 |
$0.00 |