| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,520 |
1,407 |
$64K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
353 |
353 |
$27K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
259 |
258 |
$21K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
184 |
179 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
448 |
418 |
$12K |
| 99497 |
|
107 |
107 |
$5K |
| 90686 |
|
175 |
175 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
214 |
213 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
142 |
130 |
$1K |
| 0031A |
|
28 |
28 |
$894.13 |
| 97802 |
|
119 |
119 |
$586.60 |
| 96127 |
|
139 |
135 |
$474.62 |
| 0064A |
|
12 |
12 |
$459.72 |
| 90480 |
|
13 |
13 |
$330.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$143.49 |
| 91303 |
|
29 |
29 |
$0.11 |
| 99072 |
|
14 |
14 |
$0.03 |
| 91306 |
|
12 |
12 |
$0.02 |
| 1123F |
|
12 |
12 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
995 |
953 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
1,077 |
1,000 |
$0.00 |
| 1124F |
|
204 |
203 |
$0.00 |
| 99080 |
|
40 |
40 |
$0.00 |