| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,631 |
2,251 |
$83K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
662 |
631 |
$25K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
78 |
74 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
42 |
42 |
$3K |
| 90688 |
|
234 |
227 |
$2K |
| 81002 |
|
839 |
795 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
25 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
68 |
58 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
27 |
25 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
106 |
101 |
$758.10 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
14 |
$668.00 |
| 90686 |
|
24 |
24 |
$575.98 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
12 |
$170.40 |
| 90461 |
|
98 |
91 |
$52.55 |
| 90687 |
|
17 |
16 |
$9.40 |
| 3008F |
|
242 |
218 |
$0.00 |
| 3074F |
|
149 |
146 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
142 |
139 |
$0.00 |
| 3017F |
|
15 |
15 |
$0.00 |
| 4037F |
|
17 |
17 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
434 |
399 |
$0.00 |
| 3078F |
|
161 |
155 |
$0.00 |
| 99072 |
|
68 |
65 |
$0.00 |
| 4274F |
|
12 |
12 |
$0.00 |