| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96151 |
|
123 |
123 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
38 |
38 |
$3K |
| 90686 |
|
259 |
259 |
$2K |
| 96156 |
|
309 |
309 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
24 |
24 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
687 |
673 |
$738.50 |
| 99050 |
|
12 |
12 |
$600.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$578.76 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
199 |
198 |
$327.28 |
| G9920 |
Screening performed and negative |
239 |
239 |
$232.00 |
| 92551 |
|
13 |
13 |
$171.08 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
92 |
92 |
$0.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
79 |
79 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
24 |
24 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
175 |
153 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$0.00 |