| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
777 |
774 |
$19K |
| 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 |
145 |
145 |
$5K |
| 92587 |
|
63 |
63 |
$1K |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
24 |
24 |
$505.08 |
| D1206 |
Topical application of fluoride varnish |
12 |
12 |
$360.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
13 |
13 |
$251.16 |
| 83655 |
|
12 |
12 |
$156.20 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
30 |
30 |
$108.56 |
| 90461 |
|
188 |
187 |
$96.68 |
| 97802 |
|
194 |
194 |
$89.34 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
31 |
31 |
$49.57 |
| 90686 |
|
89 |
89 |
$22.35 |
| S9451 |
Exercise classes, non-physician provider, per session |
102 |
102 |
$9.60 |
| 99173 |
|
36 |
36 |
$4.21 |
| 99080 |
|
8,253 |
537 |
$0.00 |
| 90734 |
|
14 |
14 |
$0.00 |
| 96160 |
|
63 |
63 |
$0.00 |
| 99408 |
|
14 |
14 |
$0.00 |
| 1033F |
|
94 |
94 |
$0.00 |
| 90671 |
|
40 |
39 |
$0.00 |
| 3725F |
|
14 |
14 |
$0.00 |
| G0445 |
High intensity behavioral counseling to prevent sexually transmitted infection; face-to-face, individual, includes: education, skills training and guidance on how to change sexual behavior; performed semi-annually, 30 minutes |
42 |
42 |
$0.00 |
| G9622 |
Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method |
14 |
14 |
$0.00 |
| 3016F |
|
14 |
14 |
$0.00 |
| 2000F |
|
73 |
73 |
$0.00 |
| 90680 |
|
13 |
13 |
$0.00 |
| 1031F |
|
105 |
105 |
$0.00 |
| 2010F |
|
14 |
14 |
$0.00 |
| 90698 |
|
30 |
30 |
$0.00 |
| 1000F |
|
108 |
108 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
33 |
33 |
$0.00 |
| 2001F |
|
49 |
49 |
$0.00 |
| 3008F |
|
70 |
70 |
$0.00 |
| 90744 |
|
12 |
12 |
$0.00 |
| 1220F |
|
14 |
14 |
$0.00 |
| 96127 |
|
14 |
14 |
$0.00 |
| H0001 |
Alcohol and/or drug assessment |
14 |
14 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
14 |
14 |
$0.00 |