| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,121 |
1,115 |
$45K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
656 |
630 |
$41K |
| 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 |
2,478 |
2,464 |
$32K |
| 92587 |
|
986 |
985 |
$26K |
| 99401 |
|
1,437 |
1,425 |
$20K |
| 99173 |
|
1,357 |
1,357 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
413 |
413 |
$16K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
493 |
493 |
$12K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
372 |
353 |
$12K |
| 99406 |
|
902 |
701 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
398 |
398 |
$7K |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
429 |
429 |
$4K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
147 |
147 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
285 |
285 |
$4K |
| 0001A |
|
97 |
97 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
164 |
164 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
1,362 |
1,362 |
$4K |
| D1206 |
Topical application of fluoride varnish |
105 |
105 |
$3K |
| 97802 |
|
139 |
139 |
$2K |
| 0053A |
|
18 |
18 |
$729.78 |
| 0051A |
|
13 |
13 |
$549.34 |
| 91305 |
|
41 |
41 |
$540.27 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
84 |
83 |
$269.34 |
| 90686 |
|
199 |
198 |
$19.03 |
| H0001 |
Alcohol and/or drug assessment |
455 |
455 |
$2.15 |
| 99408 |
|
455 |
455 |
$2.14 |
| S9451 |
Exercise classes, non-physician provider, per session |
984 |
984 |
$0.00 |
| 3008F |
|
137 |
137 |
$0.00 |
| G9275 |
Documentation that patient is a current non-tobacco user |
368 |
368 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
454 |
454 |
$0.00 |
| 90647 |
|
41 |
41 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
731 |
731 |
$0.00 |
| 1000F |
|
442 |
442 |
$0.00 |
| 1036F |
|
398 |
398 |
$0.00 |
| 90680 |
|
38 |
38 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
15 |
15 |
$0.00 |
| 90620 |
|
22 |
22 |
$0.00 |
| 36406 |
|
31 |
31 |
$0.00 |
| 90660 |
|
53 |
53 |
$0.00 |
| 90656 |
|
67 |
67 |
$0.00 |
| 90723 |
|
15 |
15 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
261 |
261 |
$0.00 |
| 3725F |
|
443 |
443 |
$0.00 |
| 99080 |
|
226 |
52 |
$0.00 |
| 90685 |
|
146 |
145 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
74 |
74 |
$0.00 |
| 90670 |
|
64 |
64 |
$0.00 |
| 90633 |
|
42 |
41 |
$0.00 |
| 90672 |
|
18 |
18 |
$0.00 |
| 91300 |
|
71 |
71 |
$0.00 |
| 90734 |
|
32 |
32 |
$0.00 |