| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S9083 |
Global fee urgent care centers |
181 |
176 |
$18K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
136 |
129 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
340 |
338 |
$5K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
107 |
106 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
93 |
92 |
$2K |
| 0011A |
|
65 |
64 |
$399.69 |
| 0012A |
|
72 |
72 |
$360.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
16 |
16 |
$200.37 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
55 |
54 |
$197.64 |
| 92552 |
|
131 |
130 |
$137.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
43 |
43 |
$79.52 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
85 |
85 |
$79.07 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
87 |
87 |
$78.57 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
34 |
34 |
$30.24 |
| 36415 |
Collection of venous blood by venipuncture |
123 |
119 |
$10.60 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
161 |
161 |
$0.00 |
| 90686 |
|
181 |
180 |
$0.00 |
| 99000 |
|
57 |
54 |
$0.00 |
| 3008F |
|
206 |
204 |
$0.00 |
| 1000F |
|
31 |
31 |
$0.00 |
| 1036F |
|
31 |
31 |
$0.00 |
| 91301 |
|
134 |
128 |
$0.00 |
| 99174 |
|
145 |
144 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
30 |
30 |
$0.00 |
| H0001 |
Alcohol and/or drug assessment |
15 |
15 |
$0.00 |
| 90651 |
|
13 |
13 |
$0.00 |
| 97803 |
|
245 |
245 |
$0.00 |
| 3016F |
|
32 |
32 |
$0.00 |
| 99080 |
|
511 |
47 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
56 |
56 |
$0.00 |
| 3725F |
|
31 |
31 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| G9622 |
Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method |
16 |
16 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |