| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,302 |
2,949 |
$119K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
743 |
739 |
$57K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,020 |
977 |
$51K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
505 |
485 |
$37K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,304 |
976 |
$22K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
177 |
176 |
$14K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
390 |
189 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
484 |
326 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
42 |
42 |
$4K |
| 90461 |
|
802 |
633 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
289 |
282 |
$3K |
| 92587 |
|
495 |
489 |
$1K |
| 99460 |
|
13 |
13 |
$866.25 |
| 99238 |
Hospital discharge day management, 30 minutes or less |
13 |
13 |
$652.30 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
13 |
13 |
$585.00 |
| 87807 |
|
44 |
43 |
$440.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$300.48 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
13 |
$178.75 |
| 83655 |
|
26 |
26 |
$142.38 |
| CP002 |
|
13 |
13 |
$127.40 |
| 90473 |
|
13 |
12 |
$55.00 |
| 94760 |
|
29 |
28 |
$31.36 |
| 85018 |
|
54 |
54 |
$29.85 |
| 99001 |
|
14 |
14 |
$27.00 |
| 90697 |
|
41 |
39 |
$0.11 |
| 4124F |
|
168 |
158 |
$0.00 |
| 90670 |
|
326 |
321 |
$0.00 |
| 99173 |
|
106 |
106 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
102 |
102 |
$0.00 |
| 4120F |
|
16 |
16 |
$0.00 |
| 4035F |
|
98 |
96 |
$0.00 |
| 90633 |
|
14 |
13 |
$0.00 |
| 1036F |
|
462 |
428 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
607 |
601 |
$0.00 |
| 3008F |
|
1,137 |
1,130 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
689 |
684 |
$0.00 |
| 36416 |
|
175 |
171 |
$0.00 |
| 90680 |
|
53 |
53 |
$0.00 |
| 90647 |
|
68 |
67 |
$0.00 |
| 90723 |
|
92 |
91 |
$0.00 |
| 90686 |
|
76 |
75 |
$0.00 |
| 99174 |
|
94 |
93 |
$0.00 |