| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,960 |
1,766 |
$54K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,321 |
1,248 |
$25K |
| 99401 |
|
1,164 |
1,054 |
$12K |
| 92552 |
|
1,022 |
1,019 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
192 |
192 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
124 |
122 |
$3K |
| H0001 |
Alcohol and/or drug assessment |
331 |
330 |
$3K |
| 90686 |
|
874 |
871 |
$2K |
| 99173 |
|
634 |
632 |
$1K |
| 99442 |
|
41 |
40 |
$1K |
| 81003 |
|
608 |
605 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
1,101 |
1,083 |
$1K |
| 0072A |
|
19 |
19 |
$675.64 |
| 99441 |
|
31 |
31 |
$633.17 |
| 0073A |
|
14 |
14 |
$588.73 |
| 0071A |
|
14 |
14 |
$400.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
162 |
162 |
$324.79 |
| D1206 |
Topical application of fluoride varnish |
13 |
13 |
$305.98 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
28 |
28 |
$163.49 |
| 3008F |
|
863 |
857 |
$0.00 |
| 1000F |
|
199 |
199 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
159 |
159 |
$0.00 |
| 91307 |
|
60 |
56 |
$0.00 |
| 1036F |
|
102 |
102 |
$0.00 |
| 3725F |
|
160 |
160 |
$0.00 |
| G8780 |
Counseling for diet and physical activity performed |
18 |
18 |
$0.00 |
| S9470 |
Nutritional counseling, dietitian visit |
14 |
14 |
$0.00 |
| 3016F |
|
13 |
13 |
$0.00 |