| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,585 |
3,984 |
$43K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
963 |
960 |
$33K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
818 |
817 |
$24K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
810 |
796 |
$23K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
343 |
343 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
515 |
511 |
$826.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
68 |
68 |
$370.72 |
| 96127 |
|
166 |
166 |
$17.64 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
223 |
221 |
$0.00 |
| G9459 |
Currently a tobacco non-user |
90 |
90 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
102 |
102 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
112 |
112 |
$0.00 |
| S9999 |
Sales tax |
1,779 |
1,519 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
18 |
18 |
$0.00 |