| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
356 |
355 |
$17K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
195 |
195 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
132 |
132 |
$9K |
| 90461 |
|
191 |
190 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
514 |
432 |
$7K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
281 |
280 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
91 |
88 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
53 |
53 |
$3K |
| 92587 |
|
115 |
114 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
34 |
34 |
$2K |
| 92551 |
|
107 |
107 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
13 |
$1K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
92 |
91 |
$1K |
| 81000 |
|
155 |
154 |
$521.66 |
| 83655 |
|
15 |
15 |
$163.50 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
16 |
16 |
$111.84 |
| 1031F |
|
597 |
591 |
$25.00 |
| 90671 |
|
26 |
26 |
$0.00 |
| 99080 |
|
2,158 |
320 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |
| 99177 |
|
73 |
73 |
$0.00 |
| 90681 |
|
12 |
12 |
$0.00 |
| 99173 |
|
61 |
61 |
$0.00 |
| 90697 |
|
43 |
43 |
$0.00 |
| 97802 |
|
208 |
208 |
$0.00 |
| 90686 |
|
26 |
26 |
$0.00 |
| 90677 |
|
50 |
50 |
$0.00 |
| 99000 |
|
46 |
45 |
$0.00 |
| 90674 |
|
18 |
18 |
$0.00 |
| 36416 |
|
16 |
16 |
$0.00 |
| 96127 |
|
18 |
18 |
$0.00 |