| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,683 |
6,638 |
$70K |
| 96160 |
|
2,803 |
2,766 |
$14K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
2,167 |
2,167 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,790 |
2,691 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,559 |
1,559 |
$7K |
| 90686 |
|
2,612 |
2,612 |
$5K |
| 85018 |
|
2,412 |
2,410 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,140 |
1,133 |
$3K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
780 |
780 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,425 |
1,425 |
$2K |
| 81003 |
|
1,215 |
1,215 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
727 |
726 |
$1K |
| 92551 |
|
777 |
777 |
$930.73 |
| 90461 |
|
1,102 |
1,101 |
$903.32 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
112 |
112 |
$730.07 |
| H0001 |
Alcohol and/or drug assessment |
1,808 |
1,808 |
$660.83 |
| 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 |
1,498 |
1,498 |
$552.22 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,691 |
1,664 |
$455.99 |
| 86580 |
|
60 |
60 |
$430.29 |
| 90670 |
|
87 |
87 |
$232.05 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
104 |
104 |
$149.16 |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
31 |
31 |
$142.63 |
| 92567 |
|
84 |
83 |
$109.74 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
313 |
313 |
$98.31 |
| 36415 |
Collection of venous blood by venipuncture |
3,627 |
3,466 |
$93.00 |
| 90680 |
|
12 |
12 |
$89.25 |
| 81002 |
|
346 |
346 |
$56.25 |
| 99173 |
|
490 |
490 |
$34.72 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,707 |
1,707 |
$12.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
1,474 |
1,474 |
$0.67 |
| G9622 |
Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method |
1,749 |
1,749 |
$0.65 |
| 83655 |
|
40 |
40 |
$0.29 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,378 |
1,378 |
$0.28 |
| G9820 |
Documentation of a chlamydia screening test with proper follow-up |
1,009 |
1,009 |
$0.27 |
| 3008F |
|
8,691 |
8,360 |
$0.01 |
| 99408 |
|
1,953 |
1,953 |
$0.01 |
| 1000F |
|
1,540 |
1,540 |
$0.00 |
| 90620 |
|
79 |
79 |
$0.00 |
| 36416 |
|
2,360 |
2,358 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
382 |
382 |
$0.00 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
160 |
160 |
$0.00 |
| 97802 |
|
747 |
747 |
$0.00 |
| 1031F |
|
2,960 |
2,958 |
$0.00 |
| 1036F |
|
1,533 |
1,533 |
$0.00 |
| 90651 |
|
271 |
271 |
$0.00 |
| 90656 |
|
178 |
178 |
$0.00 |
| 91307 |
|
85 |
79 |
$0.00 |
| G9416 |
Patient had one tetanus, diphtheria toxoids and acellular pertussis vaccine (tdap) on or between the patient's 10th and 13th birthdays |
13 |
13 |
$0.00 |
| 91305 |
|
26 |
26 |
$0.00 |
| 3725F |
|
1,569 |
1,567 |
$0.00 |
| 3016F |
|
1,533 |
1,533 |
$0.00 |
| 1033F |
|
2,939 |
2,937 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
13 |
$0.00 |
| 90734 |
|
93 |
93 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
67 |
67 |
$0.00 |
| 91300 |
|
20 |
17 |
$0.00 |
| G9762 |
Patient had at least two hpv vaccines (with at least 146 days between the two) or three hpv vaccines on or between the patient's 9th and 13th birthdays |
12 |
12 |
$0.00 |
| 90715 |
|
25 |
25 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
13 |
13 |
$0.00 |
| G9414 |
Patient had one dose of meningococcal vaccine (serogroups a, c, w, y or a, c, w, y, b) on or between the patient's 10th and 13th birthdays |
14 |
14 |
$0.00 |