| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,982 |
3,658 |
$70K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
333 |
328 |
$23K |
| G9920 |
Screening performed and negative |
873 |
868 |
$14K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
265 |
265 |
$14K |
| Z1034 |
|
158 |
114 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
146 |
143 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
50 |
46 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
77 |
76 |
$3K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
12 |
12 |
$2K |
| 90686 |
|
93 |
93 |
$2K |
| 92552 |
|
68 |
68 |
$907.14 |
| 85018 |
|
700 |
695 |
$846.98 |
| 81000 |
|
586 |
586 |
$822.06 |
| 90674 |
|
19 |
19 |
$381.80 |
| A4267 |
Contraceptive supply, condom, male, each |
42 |
42 |
$352.80 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
53 |
53 |
$207.38 |
| 83026 |
|
76 |
76 |
$197.58 |
| 90756 |
|
23 |
23 |
$189.44 |
| 90670 |
|
37 |
37 |
$189.00 |
| H0049 |
Alcohol and/or drug screening |
966 |
949 |
$182.44 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
922 |
896 |
$156.55 |
| 90658 |
|
36 |
35 |
$146.85 |
| 99000 |
|
39 |
39 |
$139.73 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
95 |
88 |
$113.68 |
| 81003 |
|
45 |
45 |
$91.35 |
| 1036F |
|
999 |
982 |
$76.68 |
| 90657 |
|
25 |
25 |
$61.20 |
| 93000 |
|
16 |
13 |
$30.00 |
| 96127 |
|
63 |
63 |
$19.04 |
| 90734 |
|
12 |
12 |
$18.00 |
| 92081 |
|
12 |
12 |
$15.20 |