| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
784 |
771 |
$14K |
| 87110 |
|
234 |
234 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
716 |
647 |
$2K |
| 90686 |
|
386 |
386 |
$1K |
| 99442 |
|
253 |
253 |
$1K |
| 92551 |
|
853 |
853 |
$762.71 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
144 |
144 |
$700.46 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
119 |
119 |
$557.46 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
15 |
15 |
$495.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
48 |
48 |
$435.00 |
| 90651 |
|
15 |
15 |
$295.00 |
| 90620 |
|
16 |
16 |
$220.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
16 |
14 |
$201.62 |
| 97802 |
|
435 |
435 |
$107.35 |
| H0001 |
Alcohol and/or drug assessment |
429 |
429 |
$58.30 |
| 90656 |
|
31 |
31 |
$40.00 |
| 36415 |
Collection of venous blood by venipuncture |
889 |
878 |
$20.49 |
| 99173 |
|
791 |
790 |
$14.07 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
412 |
412 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
417 |
417 |
$0.00 |
| 3008F |
|
1,458 |
1,319 |
$0.00 |
| 3044F |
|
76 |
76 |
$0.00 |
| 1036F |
|
184 |
184 |
$0.00 |
| 1000F |
|
172 |
172 |
$0.00 |
| 3725F |
|
186 |
186 |
$0.00 |
| 3016F |
|
173 |
173 |
$0.00 |
| 1160F |
|
292 |
265 |
$0.00 |
| G9622 |
Patient not identified as an unhealthy alcohol user when screened for unhealthy alcohol use using a systematic screening method |
414 |
414 |
$0.00 |
| 1159F |
|
404 |
377 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
14 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
15 |
15 |
$0.00 |
| 90661 |
|
27 |
27 |
$0.00 |