| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 92551 |
|
2,511 |
2,501 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
8,579 |
8,243 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
529 |
528 |
$609.43 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
878 |
878 |
$328.45 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
589 |
589 |
$298.05 |
| 99000 |
|
6,490 |
6,419 |
$284.53 |
| 90658 |
|
260 |
260 |
$203.22 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
2,466 |
2,462 |
$136.00 |
| 88150 |
|
21 |
21 |
$135.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,138 |
2,121 |
$129.30 |
| 86580 |
|
110 |
107 |
$120.78 |
| 3008F |
|
8,665 |
8,330 |
$103.71 |
| 80061 |
Lipid panel |
4,392 |
4,376 |
$103.59 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
579 |
565 |
$67.12 |
| 3079F |
|
2,075 |
2,035 |
$60.83 |
| 90649 |
|
43 |
43 |
$51.00 |
| 81002 |
|
2,576 |
2,571 |
$44.67 |
| 90734 |
|
374 |
374 |
$27.00 |
| 84443 |
Thyroid stimulating hormone (TSH) |
3,492 |
3,470 |
$24.00 |
| 80053 |
Comprehensive metabolic panel |
4,515 |
4,494 |
$18.10 |
| 90715 |
|
71 |
71 |
$18.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
5,680 |
5,655 |
$13.36 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
94 |
93 |
$11.50 |
| 3078F |
|
4,497 |
4,376 |
$11.04 |
| 83655 |
|
38 |
38 |
$10.52 |
| 81007 |
|
113 |
111 |
$2.76 |
| 3077F |
|
907 |
893 |
$0.00 |
| 90648 |
|
13 |
13 |
$0.00 |
| 3046F |
|
12 |
12 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$0.00 |
| 90670 |
|
26 |
26 |
$0.00 |
| 3044F |
|
1,330 |
1,327 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
2,325 |
2,317 |
$0.00 |
| 3074F |
|
5,516 |
5,344 |
$0.00 |
| 3075F |
|
510 |
508 |
$0.00 |
| 3080F |
|
421 |
412 |
$0.00 |
| 2000F |
|
2,685 |
2,680 |
$0.00 |
| 84153 |
|
322 |
321 |
$0.00 |
| 82043 |
|
143 |
143 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
33 |
31 |
$0.00 |
| 1220F |
|
135 |
135 |
$0.00 |