| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,663 |
2,423 |
$135K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
547 |
547 |
$36K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
501 |
501 |
$34K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
438 |
438 |
$31K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
405 |
393 |
$23K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,344 |
1,341 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
228 |
225 |
$18K |
| 92587 |
|
1,109 |
1,106 |
$12K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
363 |
355 |
$5K |
| 97802 |
|
803 |
802 |
$2K |
| 81002 |
|
822 |
817 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
52 |
52 |
$493.12 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
39 |
39 |
$421.58 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
12 |
12 |
$166.08 |
| 90621 |
|
18 |
18 |
$121.90 |
| 96127 |
|
34 |
34 |
$105.33 |
| 90686 |
|
176 |
176 |
$20.93 |
| 90716 |
|
42 |
42 |
$0.00 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
650 |
649 |
$0.00 |
| 90680 |
|
51 |
51 |
$0.00 |
| 90698 |
|
54 |
54 |
$0.00 |
| 90696 |
|
24 |
24 |
$0.00 |
| 90651 |
|
48 |
48 |
$0.00 |
| 90647 |
|
13 |
13 |
$0.00 |
| 90461 |
|
567 |
567 |
$0.00 |
| 90670 |
|
288 |
287 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
365 |
365 |
$0.00 |
| 90633 |
|
26 |
26 |
$0.00 |
| 90707 |
|
44 |
44 |
$0.00 |
| 90734 |
|
54 |
54 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |
| 90685 |
|
12 |
12 |
$0.00 |