| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
570 |
534 |
$37K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
256 |
252 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
112 |
105 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
84 |
84 |
$7K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
110 |
108 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
39 |
39 |
$4K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
19 |
19 |
$2K |
| 99460 |
|
21 |
20 |
$2K |
| 94760 |
|
223 |
215 |
$533.55 |
| 81002 |
|
144 |
137 |
$298.30 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
28 |
28 |
$263.13 |
| 94761 |
|
19 |
15 |
$54.12 |
| 85018 |
|
26 |
25 |
$51.84 |
| A4250 |
Urine test or reagent strips or tablets (100 tablets or strips) |
144 |
137 |
$4.29 |
| 99000 |
|
111 |
100 |
$0.00 |
| 90698 |
|
13 |
13 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
17 |
17 |
$0.00 |
| 99173 |
|
41 |
41 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
24 |
24 |
$0.00 |
| 90670 |
|
57 |
54 |
$0.00 |