| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
557 |
534 |
$32K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
347 |
339 |
$17K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
158 |
150 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
75 |
74 |
$6K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
153 |
149 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
56 |
55 |
$4K |
| 94760 |
|
219 |
214 |
$471.38 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
28 |
27 |
$317.39 |
| 81002 |
|
135 |
133 |
$269.94 |
| 85018 |
|
98 |
97 |
$222.30 |
| A4250 |
Urine test or reagent strips or tablets (100 tablets or strips) |
135 |
133 |
$6.11 |
| 90670 |
|
102 |
99 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
26 |
26 |
$0.00 |
| 90744 |
|
26 |
26 |
$0.00 |
| 90698 |
|
54 |
51 |
$0.00 |
| 90686 |
|
24 |
24 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
35 |
35 |
$0.00 |
| 90680 |
|
66 |
63 |
$0.00 |
| 99000 |
|
89 |
81 |
$0.00 |
| 90647 |
|
14 |
14 |
$0.00 |