| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G9920 |
Screening performed and negative |
637 |
635 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
472 |
440 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
51 |
51 |
$2K |
| 92551 |
|
336 |
336 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
181 |
76 |
$1K |
| 0071A |
|
16 |
16 |
$640.00 |
| 0072A |
|
14 |
14 |
$560.00 |
| 90713 |
|
61 |
61 |
$461.25 |
| 90700 |
|
40 |
40 |
$301.50 |
| 99000 |
|
76 |
75 |
$187.28 |
| 90670 |
|
25 |
25 |
$184.50 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$180.00 |
| 92552 |
|
14 |
14 |
$147.43 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
268 |
220 |
$130.94 |
| 90647 |
|
14 |
14 |
$117.00 |
| 90648 |
|
12 |
12 |
$76.50 |
| 92060 |
|
13 |
13 |
$15.16 |
| 3074F |
|
31 |
28 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$0.00 |
| 3078F |
|
29 |
27 |
$0.00 |
| 99173 |
|
26 |
26 |
$0.00 |