| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
682 |
647 |
$25K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
323 |
312 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
410 |
387 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
37 |
36 |
$2K |
| 96160 |
|
374 |
356 |
$963.97 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17 |
16 |
$961.12 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$768.30 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
12 |
$683.62 |
| 90686 |
|
60 |
57 |
$189.00 |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
13 |
13 |
$125.52 |
| 90698 |
|
13 |
12 |
$10.00 |
| 90670 |
|
13 |
12 |
$5.25 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
12 |
12 |
$5.20 |
| 3078F |
|
98 |
91 |
$0.00 |
| 3077F |
|
14 |
14 |
$0.00 |
| 3074F |
|
141 |
134 |
$0.00 |
| 3008F |
|
367 |
349 |
$0.00 |
| 3079F |
|
71 |
66 |
$0.00 |
| 91301 |
|
12 |
12 |
$0.00 |
| 3075F |
|
12 |
12 |
$0.00 |