| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,367 |
1,235 |
$51K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
169 |
166 |
$13K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
826 |
370 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
133 |
130 |
$10K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
214 |
213 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
499 |
247 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
82 |
82 |
$7K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
34 |
34 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
128 |
126 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
161 |
143 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$1K |
| G0402 |
Initial preventive physical examination; face-to-face visit, services limited to new beneficiary during the first 12 months of medicare enrollment |
21 |
21 |
$525.00 |
| 83655 |
|
31 |
31 |
$305.10 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
20 |
18 |
$207.60 |
| 90707 |
|
14 |
14 |
$0.00 |
| 90461 |
|
155 |
140 |
$0.00 |
| 90648 |
|
79 |
79 |
$0.00 |
| 90681 |
|
15 |
15 |
$0.00 |
| 90633 |
|
55 |
55 |
$0.00 |
| 90700 |
|
13 |
13 |
$0.00 |
| 90723 |
|
44 |
44 |
$0.00 |
| G9716 |
Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason |
159 |
158 |
$0.00 |
| 90677 |
|
109 |
109 |
$0.00 |
| 90686 |
|
171 |
171 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| 90716 |
|
15 |
15 |
$0.00 |