| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
82 |
82 |
$784.00 |
| 90656 |
|
72 |
72 |
$711.48 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
15 |
15 |
$182.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
51 |
51 |
$109.90 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
408 |
399 |
$61.94 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
26 |
26 |
$54.83 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
532 |
515 |
$51.06 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
104 |
104 |
$34.55 |
| 99000 |
|
324 |
316 |
$7.18 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
108 |
104 |
$5.96 |
| 96127 |
|
262 |
262 |
$4.81 |
| 85018 |
|
137 |
137 |
$2.07 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
201 |
201 |
$0.01 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
636 |
602 |
$0.00 |
| 81003 |
|
134 |
133 |
$0.00 |
| 92552 |
|
86 |
86 |
$0.00 |
| 1159F |
|
1,152 |
1,063 |
$0.00 |
| 3725F |
|
261 |
261 |
$0.00 |
| 1160F |
|
1,152 |
1,063 |
$0.00 |
| 99173 |
|
94 |
94 |
$0.00 |
| 3077F |
|
154 |
149 |
$0.00 |
| 3078F |
|
782 |
745 |
$0.00 |
| 4013F |
|
37 |
37 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
53 |
53 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
53 |
53 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
16 |
16 |
$0.00 |
| 3049F |
|
12 |
12 |
$0.00 |
| 3080F |
|
59 |
58 |
$0.00 |
| 1125F |
|
82 |
80 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
343 |
335 |
$0.00 |
| 4010F |
|
93 |
86 |
$0.00 |
| 3008F |
|
1,133 |
1,075 |
$0.00 |
| 1000F |
|
1,188 |
1,099 |
$0.00 |
| 1036F |
|
1,120 |
1,035 |
$0.00 |
| 3048F |
|
13 |
13 |
$0.00 |
| 2000F |
|
1,154 |
1,093 |
$0.00 |
| 3075F |
|
164 |
160 |
$0.00 |
| 99443 |
|
91 |
90 |
$0.00 |
| 3074F |
|
809 |
773 |
$0.00 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
44 |
40 |
$0.00 |
| 3079F |
|
266 |
259 |
$0.00 |
| 1126F |
|
102 |
102 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
178 |
173 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
225 |
220 |
$0.00 |
| 3044F |
|
38 |
38 |
$0.00 |
| 1034F |
|
44 |
41 |
$0.00 |
| 1170F |
|
120 |
120 |
$0.00 |