| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,501 |
5,864 |
$205K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,087 |
2,015 |
$39K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
669 |
656 |
$32K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,838 |
1,761 |
$17K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
183 |
179 |
$8K |
| 0001A |
|
184 |
183 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
806 |
782 |
$7K |
| 0002A |
|
137 |
137 |
$5K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
80 |
77 |
$5K |
| D0145 |
Oral evaluation for a patient under three years of age |
239 |
226 |
$3K |
| 0012A |
|
100 |
100 |
$3K |
| 0072A |
|
66 |
66 |
$3K |
| 93000 |
|
140 |
139 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
304 |
304 |
$3K |
| 0071A |
|
48 |
48 |
$2K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
13 |
13 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
195 |
195 |
$2K |
| 99442 |
|
15 |
13 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
118 |
118 |
$1K |
| 0011A |
|
67 |
67 |
$1K |
| 97802 |
|
26 |
26 |
$1K |
| 99401 |
|
247 |
245 |
$841.11 |
| 96127 |
|
102 |
102 |
$639.69 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
93 |
93 |
$580.28 |
| 0004A |
|
14 |
14 |
$560.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
179 |
172 |
$541.16 |
| 0064A |
|
13 |
13 |
$480.00 |
| 0031A |
|
15 |
15 |
$433.23 |
| 85049 |
|
137 |
133 |
$431.09 |
| 97803 |
|
12 |
12 |
$414.96 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
14 |
14 |
$414.60 |
| 90658 |
|
15 |
15 |
$244.80 |
| 92551 |
|
646 |
646 |
$181.60 |
| 80053 |
Comprehensive metabolic panel |
64 |
63 |
$153.00 |
| 81000 |
|
37 |
36 |
$147.28 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
39 |
39 |
$134.40 |
| 82948 |
|
29 |
25 |
$58.00 |
| 81025 |
|
17 |
17 |
$34.34 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
47 |
39 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
142 |
138 |
$0.00 |