| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,662 |
7,137 |
$15K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
131 |
130 |
$5K |
| 92552 |
|
334 |
334 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
963 |
955 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
737 |
708 |
$3K |
| 90686 |
|
225 |
224 |
$1K |
| 99173 |
|
478 |
478 |
$978.30 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
103 |
103 |
$548.00 |
| 83026 |
|
247 |
247 |
$528.82 |
| 92551 |
|
88 |
88 |
$434.06 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$417.97 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
1,649 |
1,648 |
$414.94 |
| 90658 |
|
35 |
35 |
$384.12 |
| 81003 |
|
174 |
174 |
$332.82 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
87 |
87 |
$180.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$150.60 |
| 85018 |
|
125 |
125 |
$120.39 |
| 81000 |
|
201 |
196 |
$64.80 |
| 86580 |
|
13 |
13 |
$47.91 |
| 90620 |
|
40 |
40 |
$10.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
1,663 |
1,654 |
$0.16 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,117 |
1,116 |
$0.10 |
| 97803 |
|
120 |
120 |
$0.03 |
| 3078F |
|
4,986 |
4,541 |
$0.00 |
| 3077F |
|
129 |
116 |
$0.00 |
| 3074F |
|
5,660 |
5,113 |
$0.00 |
| 3075F |
|
372 |
356 |
$0.00 |
| 3008F |
|
7,357 |
6,563 |
$0.00 |
| 3079F |
|
1,605 |
1,543 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
96 |
96 |
$0.00 |
| 3080F |
|
31 |
29 |
$0.00 |