| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
586 |
529 |
$38K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
159 |
149 |
$14K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
281 |
269 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
114 |
109 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
93 |
90 |
$8K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
131 |
125 |
$5K |
| 94760 |
|
227 |
207 |
$573.70 |
| 81002 |
|
181 |
175 |
$348.42 |
| 85018 |
|
127 |
120 |
$289.62 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
14 |
14 |
$103.60 |
| A4250 |
Urine test or reagent strips or tablets (100 tablets or strips) |
180 |
175 |
$6.63 |
| 99173 |
|
12 |
12 |
$0.00 |
| 90670 |
|
111 |
105 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
14 |
14 |
$0.00 |
| 90633 |
|
13 |
12 |
$0.00 |
| 90686 |
|
13 |
13 |
$0.00 |
| 90698 |
|
60 |
55 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
25 |
25 |
$0.00 |
| 90680 |
|
42 |
42 |
$0.00 |
| 99000 |
|
122 |
98 |
$0.00 |