| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90656 |
|
183 |
182 |
$1K |
| 90660 |
|
34 |
34 |
$686.46 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
218 |
216 |
$374.58 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
284 |
265 |
$200.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
86 |
72 |
$186.72 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,920 |
1,684 |
$124.82 |
| 99401 |
|
1,099 |
1,006 |
$93.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
441 |
439 |
$63.77 |
| H0001 |
Alcohol and/or drug assessment |
190 |
188 |
$30.00 |
| 36415 |
Collection of venous blood by venipuncture |
911 |
902 |
$17.10 |
| 3016F |
|
91 |
91 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
121 |
119 |
$0.00 |
| 83655 |
|
13 |
13 |
$0.00 |
| 99173 |
|
39 |
39 |
$0.00 |
| 3725F |
|
63 |
63 |
$0.00 |
| G9622 |
Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method |
63 |
63 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
47 |
46 |
$0.00 |
| 3008F |
|
2,092 |
1,817 |
$0.00 |
| 81000 |
|
78 |
78 |
$0.00 |
| 1036F |
|
63 |
63 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
51 |
51 |
$0.00 |
| 1000F |
|
77 |
77 |
$0.00 |