| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 93000 |
|
804 |
756 |
$15K |
| 90662 |
|
148 |
145 |
$7K |
| 90686 |
|
347 |
346 |
$3K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
83 |
73 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,501 |
11,451 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,139 |
5,774 |
$817.72 |
| 90658 |
|
31 |
31 |
$376.46 |
| 99397 |
|
66 |
65 |
$117.22 |
| 82962 |
|
5,704 |
5,085 |
$33.66 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
47 |
45 |
$18.76 |
| 81002 |
|
1,431 |
1,387 |
$2.13 |
| 3079F |
|
2,681 |
2,597 |
$0.00 |
| 3044F |
|
252 |
247 |
$0.00 |
| 3074F |
|
2,214 |
2,140 |
$0.00 |
| 3075F |
|
1,489 |
1,443 |
$0.00 |
| 1111F |
|
3,013 |
2,919 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
2,172 |
2,107 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
236 |
232 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
4,078 |
3,877 |
$0.00 |
| 3080F |
|
453 |
427 |
$0.00 |
| 85018 |
|
619 |
616 |
$0.00 |
| 3048F |
|
46 |
46 |
$0.00 |
| 1125F |
|
454 |
441 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
438 |
425 |
$0.00 |
| 99386 |
|
12 |
12 |
$0.00 |
| 3049F |
|
94 |
94 |
$0.00 |
| 3008F |
|
39 |
39 |
$0.00 |
| 93922 |
|
63 |
61 |
$0.00 |
| 1170F |
|
68 |
68 |
$0.00 |
| 82270 |
|
12 |
12 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
13 |
13 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
16 |
15 |
$0.00 |
| 3078F |
|
1,424 |
1,367 |
$0.00 |
| 4013F |
|
1,936 |
1,873 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
52 |
52 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
424 |
420 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
84 |
75 |
$0.00 |
| 3077F |
|
958 |
901 |
$0.00 |
| G8511 |
Screening for depression documented as positive, follow-up plan not documented, reason not given |
135 |
133 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,115 |
1,115 |
$0.00 |
| 0556F |
|
2,250 |
2,171 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
1,198 |
1,144 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
3,103 |
3,018 |
$0.00 |
| 3050F |
|
41 |
41 |
$0.00 |
| H0047 |
Alcohol and/or other drug abuse services, not otherwise specified |
102 |
99 |
$0.00 |
| G0473 |
Face-to-face behavioral counseling for obesity, group (2-10), 30 minutes |
1,311 |
1,256 |
$0.00 |
| 1159F |
|
237 |
234 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
42 |
42 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
54 |
54 |
$0.00 |
| 99499 |
|
12 |
12 |
$0.00 |