| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,161 |
4,015 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
179 |
179 |
$360.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
83 |
83 |
$120.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
25 |
24 |
$120.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
74 |
37 |
$33.16 |
| 92552 |
|
42 |
42 |
$15.10 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
563 |
526 |
$12.00 |
| 85018 |
|
60 |
60 |
$6.54 |
| 81002 |
|
31 |
31 |
$3.54 |
| 99173 |
|
42 |
42 |
$2.12 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
103 |
94 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
178 |
177 |
$0.00 |
| 96127 |
|
197 |
197 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
115 |
115 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
26 |
26 |
$0.00 |
| G9459 |
Currently a tobacco non-user |
12 |
12 |
$0.00 |