| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,849 |
1,600 |
$103K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,145 |
1,112 |
$21K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
67 |
67 |
$6K |
| 81000 |
|
706 |
703 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
28 |
28 |
$1K |
| 90461 |
|
100 |
100 |
$1K |
| 0072A |
|
18 |
18 |
$825.66 |
| 0071A |
|
15 |
15 |
$688.05 |
| 90686 |
|
453 |
451 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
50 |
49 |
$0.00 |
| 90688 |
|
12 |
12 |
$0.00 |
| 90672 |
|
12 |
12 |
$0.00 |
| 90734 |
|
16 |
16 |
$0.00 |
| 90685 |
|
28 |
28 |
$0.00 |