| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,079 |
1,011 |
$56K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
119 |
117 |
$9K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
374 |
367 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
78 |
78 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
39 |
39 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
443 |
440 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
134 |
131 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$1K |
| 90686 |
|
212 |
207 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$910.12 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
15 |
15 |
$129.05 |
| 81025 |
|
12 |
12 |
$86.70 |
| 81003 |
|
41 |
40 |
$58.48 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
49 |
49 |
$0.00 |
| 99173 |
|
209 |
204 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
934 |
874 |
$0.00 |
| 90685 |
|
52 |
49 |
$0.00 |
| 90734 |
|
15 |
15 |
$0.00 |
| 2028F |
|
12 |
12 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |
| 92551 |
|
149 |
146 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
454 |
441 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |