| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92551 |
|
409 |
409 |
$4K |
| 90651 |
|
180 |
180 |
$1K |
| 90734 |
|
107 |
107 |
$626.00 |
| 90686 |
|
95 |
95 |
$510.00 |
| 90715 |
|
59 |
59 |
$336.00 |
| 90620 |
|
28 |
28 |
$166.00 |
| 86580 |
|
12 |
12 |
$90.00 |
| 90633 |
|
13 |
13 |
$78.00 |
| 90696 |
|
13 |
13 |
$60.00 |
| 90710 |
|
13 |
13 |
$60.00 |
| 3008F |
|
1,005 |
1,004 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
266 |
265 |
$0.00 |
| 99441 |
|
137 |
134 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,138 |
1,067 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
30 |
30 |
$0.00 |
| 96127 |
|
83 |
83 |
$0.00 |
| 90677 |
|
29 |
28 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
333 |
333 |
$0.00 |
| 99173 |
|
631 |
631 |
$0.00 |
| 96160 |
|
49 |
49 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
405 |
405 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
199 |
199 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
13 |
$0.00 |
| G9920 |
Screening performed and negative |
178 |
178 |
$0.00 |