| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,256 |
3,820 |
$254K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,072 |
1,009 |
$92K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
884 |
881 |
$69K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
894 |
848 |
$62K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,547 |
1,498 |
$55K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
447 |
447 |
$35K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,028 |
2,002 |
$30K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
194 |
192 |
$16K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
428 |
418 |
$3K |
| 92551 |
|
640 |
639 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
804 |
802 |
$3K |
| 90461 |
|
585 |
576 |
$1K |
| 90619 |
|
30 |
30 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
185 |
184 |
$975.70 |
| 0072A |
|
17 |
17 |
$559.40 |
| 0071A |
|
13 |
13 |
$423.52 |
| 99422 |
|
14 |
13 |
$284.02 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
27 |
27 |
$146.10 |
| 99173 |
|
485 |
484 |
$138.57 |
| 83655 |
|
12 |
12 |
$123.48 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
371 |
370 |
$0.00 |
| 99000 |
|
63 |
59 |
$0.00 |
| 90674 |
|
42 |
42 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
67 |
67 |
$0.00 |
| 90688 |
|
46 |
46 |
$0.00 |
| 90647 |
|
26 |
26 |
$0.00 |
| 90686 |
|
30 |
30 |
$0.00 |
| 90680 |
|
13 |
13 |
$0.00 |
| 91307 |
|
18 |
13 |
$0.00 |
| 99072 |
|
2,590 |
2,217 |
$0.00 |
| 90670 |
|
119 |
117 |
$0.00 |
| 90661 |
|
18 |
18 |
$0.00 |