| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
635 |
569 |
$45K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
157 |
157 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
52 |
47 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
239 |
158 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
44 |
41 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
12 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 90461 |
|
68 |
61 |
$996.00 |
| 99051 |
|
45 |
42 |
$227.10 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
14 |
14 |
$207.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
17 |
17 |
$175.95 |
| S9451 |
Exercise classes, non-physician provider, per session |
166 |
160 |
$0.00 |
| 90680 |
|
29 |
26 |
$0.00 |
| 90686 |
|
30 |
30 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
14 |
12 |
$0.00 |
| 90670 |
|
43 |
40 |
$0.00 |
| 99173 |
|
72 |
68 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
98 |
94 |
$0.00 |
| 97803 |
|
137 |
133 |
$0.00 |
| 90700 |
|
48 |
45 |
$0.00 |
| 90713 |
|
28 |
28 |
$0.00 |
| 90648 |
|
12 |
12 |
$0.00 |