| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,446 |
2,185 |
$81K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
328 |
289 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
33 |
33 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
37 |
37 |
$2K |
| 90686 |
|
180 |
157 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
12 |
$601.20 |
| 81002 |
|
310 |
292 |
$589.04 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
45 |
43 |
$561.75 |
| 90656 |
|
61 |
58 |
$293.94 |
| 90461 |
|
29 |
28 |
$168.16 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
36 |
33 |
$137.43 |
| 3074F |
|
88 |
85 |
$80.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
307 |
288 |
$0.00 |
| 1160F |
|
13 |
13 |
$0.00 |
| 3078F |
|
12 |
12 |
$0.00 |
| 3079F |
|
13 |
13 |
$0.00 |
| 3008F |
|
252 |
241 |
$0.00 |
| 4037F |
|
173 |
158 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
102 |
100 |
$0.00 |