| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,903 |
1,894 |
$30K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,921 |
1,847 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
457 |
457 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
431 |
430 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
265 |
264 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
43 |
41 |
$404.01 |
| 36415 |
Collection of venous blood by venipuncture |
1,651 |
1,645 |
$260.00 |
| 90734 |
|
13 |
13 |
$170.00 |
| 90688 |
|
122 |
122 |
$126.95 |
| 90686 |
|
127 |
127 |
$41.10 |
| 3016F |
|
12 |
12 |
$0.00 |
| 90461 |
|
206 |
206 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$0.00 |
| 99080 |
|
172 |
32 |
$0.00 |
| G9820 |
Documentation of a chlamydia screening test with proper follow-up |
12 |
12 |
$0.00 |
| 3725F |
|
12 |
12 |
$0.00 |
| 3008F |
|
2,385 |
2,348 |
$0.00 |
| 90656 |
|
12 |
12 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
37 |
37 |
$0.00 |
| 1000F |
|
12 |
12 |
$0.00 |
| 90619 |
|
12 |
12 |
$0.00 |