| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
551 |
550 |
$38K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
674 |
671 |
$38K |
| 96151 |
|
657 |
655 |
$12K |
| 90686 |
|
1,215 |
1,215 |
$11K |
| 96156 |
|
1,223 |
1,219 |
$11K |
| 92551 |
|
778 |
777 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,402 |
2,276 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,819 |
1,723 |
$8K |
| G9920 |
Screening performed and negative |
1,061 |
1,057 |
$3K |
| 90651 |
|
160 |
160 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
30 |
30 |
$1K |
| 90734 |
|
81 |
81 |
$836.00 |
| 99050 |
|
14 |
14 |
$700.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
388 |
388 |
$465.45 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
16 |
14 |
$400.00 |
| 90715 |
|
29 |
29 |
$261.00 |
| 90674 |
|
13 |
13 |
$117.00 |
| 99215 |
Prolong outpt/office vis |
13 |
13 |
$85.80 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
27 |
27 |
$46.90 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,133 |
1,108 |
$0.00 |
| 90461 |
|
110 |
110 |
$0.00 |
| 99173 |
|
696 |
694 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
136 |
67 |
$0.00 |
| 96160 |
|
65 |
65 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
26 |
26 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
471 |
463 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
228 |
228 |
$0.00 |
| 86403 |
|
144 |
142 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
199 |
198 |
$0.00 |
| 97802 |
|
226 |
226 |
$0.00 |
| 99174 |
|
15 |
15 |
$0.00 |
| 87428 |
|
64 |
64 |
$0.00 |