| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,467 |
5,049 |
$247K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,254 |
6,182 |
$156K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,664 |
1,663 |
$88K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,679 |
1,679 |
$83K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
948 |
947 |
$46K |
| 92552 |
|
2,532 |
2,531 |
$37K |
| 90461 |
|
881 |
877 |
$26K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
546 |
544 |
$24K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
345 |
341 |
$20K |
| 99173 |
|
2,097 |
2,093 |
$7K |
| 36415 |
Collection of venous blood by venipuncture |
4,318 |
4,290 |
$7K |
| H0049 |
Alcohol and/or drug screening |
949 |
948 |
$6K |
| 90671 |
|
41 |
41 |
$5K |
| H0001 |
Alcohol and/or drug assessment |
861 |
860 |
$5K |
| 90733 |
|
81 |
81 |
$4K |
| V5008 |
Hearing screening |
1,125 |
1,124 |
$4K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,747 |
1,683 |
$4K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
207 |
207 |
$2K |
| 90670 |
|
337 |
337 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
73 |
72 |
$1K |
| 90686 |
|
2,851 |
2,848 |
$960.33 |
| 0072A |
|
18 |
18 |
$706.32 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
131 |
131 |
$540.46 |
| 0071A |
|
12 |
12 |
$466.32 |
| 90677 |
|
12 |
12 |
$390.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
34 |
33 |
$289.20 |
| 92551 |
|
14 |
14 |
$73.14 |
| 90633 |
|
315 |
315 |
$72.00 |
| 90688 |
|
68 |
68 |
$53.52 |
| 91307 |
|
55 |
50 |
$49.75 |
| 90716 |
|
12 |
12 |
$48.00 |
| 99401 |
|
15 |
15 |
$35.22 |
| 2001F |
|
2,131 |
2,096 |
$30.00 |
| 3074F |
|
617 |
605 |
$27.50 |
| 3078F |
|
498 |
493 |
$10.00 |
| 3008F |
|
2,528 |
2,523 |
$0.00 |
| 90651 |
|
276 |
276 |
$0.00 |
| 1036F |
|
304 |
304 |
$0.00 |
| 90680 |
|
13 |
13 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
3,404 |
3,244 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
1,224 |
1,168 |
$0.00 |
| 3725F |
|
243 |
240 |
$0.00 |
| 3016F |
|
159 |
159 |
$0.00 |
| 90648 |
|
40 |
40 |
$0.00 |
| 90710 |
|
14 |
14 |
$0.00 |