| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99336 |
|
3,463 |
2,661 |
$131K |
| 99349 |
|
2,005 |
1,532 |
$78K |
| 99350 |
Prolong home eval add 15m |
455 |
360 |
$27K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
704 |
509 |
$15K |
| 99337 |
|
385 |
282 |
$15K |
| 99497 |
|
115 |
93 |
$1K |
| 99318 |
|
59 |
49 |
$831.08 |
| 99335 |
|
41 |
37 |
$727.40 |
| 99215 |
Prolong outpt/office vis |
21 |
16 |
$615.74 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
77 |
49 |
$495.43 |
| 90682 |
|
20 |
15 |
$487.44 |
| 99348 |
|
18 |
15 |
$479.34 |
| 99326 |
|
21 |
15 |
$348.77 |
| 90686 |
|
16 |
12 |
$180.27 |
| 99347 |
|
22 |
22 |
$139.50 |
| 99421 |
|
25 |
24 |
$31.91 |
| 90662 |
|
43 |
29 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
59 |
57 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
23 |
23 |
$0.00 |