| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99349 |
|
7,681 |
6,389 |
$234K |
| 99350 |
Prolong home eval add 15m |
1,197 |
1,110 |
$60K |
| 99348 |
|
2,122 |
1,814 |
$52K |
| 99490 |
Ccm add 20min |
1,655 |
1,650 |
$16K |
| 99345 |
Prolong home eval add 15m |
96 |
96 |
$14K |
| 99344 |
|
54 |
54 |
$4K |
| 99401 |
|
335 |
326 |
$2K |
| 90756 |
|
340 |
340 |
$2K |
| 99496 |
|
13 |
13 |
$850.87 |
| 99497 |
|
47 |
46 |
$778.30 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
14 |
14 |
$680.56 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
65 |
65 |
$617.02 |
| 3074F |
|
5,039 |
4,257 |
$572.36 |
| 3078F |
|
5,555 |
4,739 |
$571.54 |
| 3075F |
|
3,570 |
3,108 |
$476.60 |
| 3079F |
|
3,219 |
2,766 |
$441.48 |
| 99072 |
|
665 |
561 |
$209.89 |
| 1126F |
|
8,812 |
7,478 |
$153.64 |
| G0008 |
Administration of influenza virus vaccine |
235 |
235 |
$143.66 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
13 |
13 |
$132.57 |
| 1160F |
|
6,212 |
5,127 |
$106.89 |
| 1159F |
|
4,489 |
3,763 |
$38.89 |
| 94760 |
|
399 |
388 |
$19.47 |
| 1125F |
|
197 |
191 |
$8.50 |
| 3077F |
|
39 |
38 |
$4.62 |
| 1170F |
|
58 |
56 |
$4.25 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
762 |
637 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
3,934 |
3,285 |
$0.00 |
| 2010F |
|
216 |
213 |
$0.00 |
| 1157F |
|
58 |
56 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
2,719 |
2,267 |
$0.00 |