| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,468 |
4,567 |
$419K |
| 92587 |
|
447 |
446 |
$17K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,293 |
1,263 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
71 |
68 |
$8K |
| 87070 |
|
765 |
715 |
$6K |
| 87184 |
|
713 |
664 |
$5K |
| 99442 |
|
71 |
68 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
42 |
42 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
816 |
764 |
$3K |
| 92551 |
|
461 |
460 |
$3K |
| 87631 |
|
32 |
31 |
$3K |
| 86403 |
|
758 |
710 |
$3K |
| 99383 |
|
12 |
12 |
$1K |
| 99401 |
|
56 |
55 |
$1K |
| 97802 |
|
1,291 |
1,291 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
54 |
27 |
$791.10 |
| 99429 |
|
30 |
30 |
$262.50 |
| 92550 |
|
13 |
12 |
$256.62 |
| 99051 |
|
53 |
51 |
$231.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
12 |
12 |
$140.40 |
| 90686 |
|
147 |
147 |
$68.67 |
| 99173 |
|
449 |
449 |
$56.40 |
| 90461 |
|
38 |
37 |
$0.00 |
| 99072 |
|
49 |
45 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
304 |
303 |
$0.00 |
| 99000 |
|
50 |
46 |
$0.00 |
| 90656 |
|
31 |
31 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
13 |
13 |
$0.00 |