| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,424 |
4,090 |
$276K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,706 |
2,690 |
$76K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
842 |
781 |
$75K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
453 |
452 |
$36K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
423 |
420 |
$34K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
284 |
284 |
$25K |
| 90461 |
|
388 |
387 |
$16K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
53 |
51 |
$4K |
| 90686 |
|
906 |
905 |
$3K |
| 99401 |
|
221 |
219 |
$3K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
101 |
94 |
$2K |
| 90651 |
|
27 |
27 |
$2K |
| 96160 |
|
304 |
302 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
2,321 |
2,306 |
$1K |
| 0071A |
|
26 |
26 |
$1K |
| 99383 |
|
14 |
14 |
$825.11 |
| 0011A |
|
15 |
15 |
$714.60 |
| 96127 |
|
239 |
239 |
$372.81 |
| 99072 |
|
545 |
541 |
$253.00 |
| 90672 |
|
28 |
28 |
$112.41 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$85.40 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
12 |
12 |
$14.04 |
| 90619 |
|
12 |
12 |
$10.00 |
| 91307 |
|
56 |
48 |
$0.33 |
| 91300 |
|
86 |
81 |
$0.09 |
| 1159F |
|
1,874 |
1,758 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
46 |
46 |
$0.00 |
| 1160F |
|
1,874 |
1,758 |
$0.00 |
| 99000 |
|
42 |
38 |
$0.00 |
| 3008F |
|
109 |
109 |
$0.00 |
| 87492 |
|
29 |
28 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
29 |
29 |
$0.00 |