| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,787 |
2,600 |
$83K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,562 |
1,529 |
$31K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
670 |
647 |
$27K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,206 |
1,192 |
$23K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
433 |
433 |
$15K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
245 |
238 |
$8K |
| 90461 |
|
477 |
470 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
419 |
407 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
113 |
113 |
$4K |
| 90677 |
|
13 |
12 |
$3K |
| 90686 |
|
238 |
233 |
$659.99 |
| 99174 |
|
98 |
97 |
$295.92 |
| 90670 |
|
58 |
58 |
$226.43 |
| 90656 |
|
57 |
57 |
$207.11 |
| 96160 |
|
1,296 |
1,292 |
$126.72 |
| 90633 |
|
14 |
12 |
$38.85 |
| 96127 |
|
12 |
12 |
$30.84 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
538 |
538 |
$0.00 |
| 3008F |
|
634 |
631 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
27 |
27 |
$0.00 |
| 99173 |
|
254 |
244 |
$0.00 |