| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,575 |
1,265 |
$43K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
663 |
534 |
$14K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
317 |
271 |
$13K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
284 |
255 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
338 |
296 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
119 |
110 |
$6K |
| 90461 |
|
134 |
121 |
$5K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
43 |
41 |
$2K |
| 87428 |
|
67 |
63 |
$2K |
| 0071A |
|
21 |
21 |
$840.00 |
| 0072A |
|
20 |
20 |
$800.00 |
| 99239 |
Hospital discharge day management, more than 30 minutes |
12 |
12 |
$656.01 |
| 99460 |
|
12 |
12 |
$505.89 |
| 96127 |
|
162 |
125 |
$385.08 |
| 85018 |
|
113 |
108 |
$188.76 |
| 36415 |
Collection of venous blood by venipuncture |
136 |
126 |
$116.51 |
| 96161 |
|
28 |
24 |
$55.88 |
| 1036F |
|
1,385 |
998 |
$0.00 |
| 90697 |
|
12 |
12 |
$0.00 |
| 1101F |
|
14 |
12 |
$0.00 |
| 91307 |
|
19 |
19 |
$0.00 |
| 90677 |
|
14 |
14 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
518 |
357 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
22 |
12 |
$0.00 |
| 3288F |
|
14 |
12 |
$0.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
36 |
30 |
$0.00 |
| 4040F |
|
220 |
164 |
$0.00 |
| 90670 |
|
17 |
17 |
$0.00 |