| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
720 |
670 |
$40K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
376 |
365 |
$18K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
177 |
172 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
107 |
103 |
$9K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
209 |
202 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
72 |
69 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16 |
16 |
$1K |
| 94760 |
|
326 |
305 |
$644.79 |
| 81002 |
|
121 |
118 |
$215.61 |
| 85018 |
|
87 |
84 |
$191.92 |
| A4250 |
Urine test or reagent strips or tablets (100 tablets or strips) |
122 |
118 |
$5.20 |
| 90670 |
|
138 |
130 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
19 |
19 |
$0.00 |
| 99051 |
|
15 |
13 |
$0.00 |
| 99000 |
|
144 |
127 |
$0.00 |
| 90698 |
|
75 |
71 |
$0.00 |
| 90680 |
|
42 |
42 |
$0.00 |
| 90647 |
|
13 |
12 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
17 |
17 |
$0.00 |
| 90686 |
|
18 |
18 |
$0.00 |
| 90744 |
|
13 |
13 |
$0.00 |