| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
858 |
855 |
$21K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
672 |
634 |
$18K |
| 87110 |
|
136 |
136 |
$3K |
| D1206 |
Topical application of fluoride varnish |
85 |
85 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
840 |
765 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,004 |
955 |
$2K |
| 86580 |
|
118 |
118 |
$1K |
| H0001 |
Alcohol and/or drug assessment |
730 |
694 |
$550.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
196 |
196 |
$542.31 |
| 97803 |
|
1,456 |
1,425 |
$373.35 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
79 |
79 |
$223.36 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
167 |
162 |
$123.79 |
| G9820 |
Documentation of a chlamydia screening test with proper follow-up |
152 |
151 |
$75.00 |
| 97802 |
|
129 |
129 |
$65.97 |
| 90686 |
|
481 |
481 |
$58.59 |
| 3008F |
|
3,391 |
2,982 |
$0.03 |
| 3016F |
|
609 |
576 |
$0.00 |
| 1033F |
|
969 |
967 |
$0.00 |
| 3725F |
|
1,173 |
1,091 |
$0.00 |
| 1003F |
|
1,359 |
1,357 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
126 |
122 |
$0.00 |
| G0270 |
Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes |
13 |
13 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
15 |
15 |
$0.00 |
| 1000F |
|
659 |
617 |
$0.00 |
| G9275 |
Documentation that patient is a current non-tobacco user |
568 |
531 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
462 |
443 |
$0.00 |
| 1036F |
|
635 |
600 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
721 |
671 |
$0.00 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
181 |
166 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
172 |
170 |
$0.00 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
12 |
12 |
$0.00 |
| 1031F |
|
17 |
17 |
$0.00 |