| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
368 |
350 |
$3K |
| 0001A |
|
49 |
49 |
$2K |
| 0002A |
|
40 |
40 |
$1K |
| 90656 |
|
73 |
72 |
$41.62 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
525 |
487 |
$0.00 |
| D0120 |
Periodic oral evaluation - established patient |
74 |
74 |
$0.00 |
| 92587 |
|
113 |
113 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
278 |
275 |
$0.00 |
| 90651 |
|
15 |
15 |
$0.00 |
| 99441 |
|
32 |
30 |
$0.00 |
| 87320 |
|
12 |
12 |
$0.00 |
| H0001 |
Alcohol and/or drug assessment |
12 |
12 |
$0.00 |
| 97803 |
|
188 |
188 |
$0.00 |
| 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 |
217 |
217 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
13 |
13 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
251 |
221 |
$0.00 |
| 99408 |
|
13 |
13 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16 |
16 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$0.00 |
| 99173 |
|
95 |
95 |
$0.00 |
| G9622 |
Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method |
12 |
12 |
$0.00 |
| 90461 |
|
13 |
12 |
$0.00 |