| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
606 |
496 |
$29K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
301 |
291 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
512 |
505 |
$5K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
361 |
359 |
$2K |
| 99401 |
|
121 |
115 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
99 |
98 |
$836.31 |
| A4927 |
Gloves, non-sterile, per 100 |
340 |
334 |
$546.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
53 |
52 |
$400.06 |
| 99177 |
|
162 |
161 |
$225.26 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
20 |
20 |
$199.71 |
| A4245 |
Alcohol wipes, per box |
310 |
306 |
$160.10 |
| 99441 |
|
15 |
15 |
$152.15 |
| 90474 |
|
12 |
12 |
$116.78 |
| 97802 |
|
102 |
102 |
$84.08 |
| 85018 |
|
13 |
13 |
$25.40 |
| 90461 |
|
154 |
150 |
$23.38 |
| 36415 |
Collection of venous blood by venipuncture |
114 |
113 |
$15.00 |
| 36416 |
|
13 |
13 |
$5.00 |
| G8427 |
Eligible clinician attests to documenting in the medical record they obtained, updated, or reviewed the patient's current medications |
360 |
356 |
$2.00 |
| 3008F |
|
45 |
45 |
$0.00 |
| 1159F |
|
360 |
356 |
$0.00 |
| 90672 |
|
12 |
12 |
$0.00 |
| 90671 |
|
12 |
12 |
$0.00 |
| A6413 |
Adhesive bandage, first-aid type, any size, each |
262 |
257 |
$0.00 |
| 90670 |
|
14 |
13 |
$0.00 |
| 99001 |
|
14 |
14 |
$0.00 |