| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 1126F |
|
590 |
590 |
$49K |
| 88141 |
|
125 |
56 |
$6K |
| 90662 |
|
155 |
155 |
$6K |
| 90715 |
|
118 |
116 |
$4K |
| 90674 |
|
156 |
92 |
$2K |
| 90686 |
|
113 |
113 |
$1K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
104 |
104 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,030 |
3,010 |
$772.28 |
| 90688 |
|
51 |
51 |
$579.60 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
909 |
907 |
$412.35 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
1,232 |
1,229 |
$394.29 |
| 99497 |
|
15 |
15 |
$344.45 |
| 97803 |
|
1,661 |
1,656 |
$335.11 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
606 |
603 |
$230.50 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
156 |
156 |
$142.32 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
2,284 |
2,277 |
$133.23 |
| 99406 |
|
1,539 |
1,534 |
$65.69 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
252 |
252 |
$46.88 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
349 |
349 |
$44.56 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
246 |
233 |
$34.55 |
| 94760 |
|
448 |
447 |
$25.04 |
| 99442 |
|
55 |
55 |
$24.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
423 |
408 |
$22.91 |
| 81002 |
|
246 |
244 |
$6.95 |
| G0328 |
Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous |
36 |
36 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
659 |
656 |
$0.00 |
| 3017F |
|
599 |
597 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
76 |
76 |
$0.00 |
| 3008F |
|
2,445 |
2,433 |
$0.00 |
| 1157F |
|
266 |
265 |
$0.00 |
| 3074F |
|
2,258 |
2,241 |
$0.00 |
| 3075F |
|
74 |
74 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
770 |
768 |
$0.00 |
| 3014F |
|
133 |
133 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
954 |
951 |
$0.00 |
| 1220F |
|
1,355 |
1,351 |
$0.00 |
| 99000 |
|
1,409 |
1,406 |
$0.00 |
| 1125F |
|
100 |
100 |
$0.00 |
| 3079F |
|
259 |
259 |
$0.00 |
| 1170F |
|
540 |
538 |
$0.00 |
| 1036F |
|
32 |
32 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
41 |
41 |
$0.00 |
| 81000 |
|
53 |
53 |
$0.00 |
| 0012A |
|
12 |
12 |
$0.00 |
| 97802 |
|
13 |
13 |
$0.00 |
| 85018 |
|
12 |
12 |
$0.00 |
| G0103 |
Prostate cancer screening; prostate specific antigen test (psa) |
24 |
24 |
$0.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
109 |
109 |
$0.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
35 |
35 |
$0.00 |
| 3078F |
|
2,174 |
2,157 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
683 |
682 |
$0.00 |
| 1159F |
|
911 |
905 |
$0.00 |
| 99408 |
|
664 |
664 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
103 |
103 |
$0.00 |
| 3725F |
|
618 |
617 |
$0.00 |
| 1160F |
|
914 |
908 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
45 |
45 |
$0.00 |
| 3077F |
|
69 |
68 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
15 |
15 |
$0.00 |