| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
435 |
400 |
$27K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
188 |
182 |
$26K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
178 |
169 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
208 |
194 |
$19K |
| 92552 |
|
201 |
194 |
$5K |
| 99215 |
Prolong outpt/office vis |
34 |
28 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
43 |
41 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
32 |
32 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
239 |
226 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
408 |
323 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
59 |
39 |
$807.64 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
470 |
324 |
$770.55 |
| 90686 |
|
89 |
89 |
$469.63 |
| 99173 |
|
265 |
257 |
$456.45 |
| 90461 |
|
204 |
108 |
$177.55 |
| 99072 |
|
1,078 |
950 |
$157.68 |
| 83655 |
|
253 |
242 |
$77.52 |
| 90670 |
|
12 |
12 |
$70.00 |
| 96161 |
|
29 |
29 |
$32.70 |
| 85013 |
|
246 |
236 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
184 |
179 |
$0.00 |
| 99000 |
|
209 |
193 |
$0.00 |
| 85018 |
|
247 |
237 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
45 |
44 |
$0.00 |