| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0280 |
Medical home program, comprehensive care coordination and planning, initial plan |
488 |
333 |
$22K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
461 |
327 |
$11K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
580 |
448 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
70 |
62 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
91 |
72 |
$5K |
| 99502 |
|
59 |
54 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
149 |
90 |
$3K |
| 87210 |
|
523 |
373 |
$2K |
| 82120 |
|
491 |
347 |
$2K |
| 99501 |
|
33 |
26 |
$1K |
| 96127 |
|
419 |
219 |
$1K |
| T1002 |
Rn services, up to 15 minutes |
39 |
37 |
$1K |
| 85018 |
|
375 |
227 |
$653.79 |
| 81025 |
|
50 |
43 |
$305.52 |
| 36415 |
Collection of venous blood by venipuncture |
70 |
57 |
$144.56 |
| 81003 |
|
18 |
12 |
$69.33 |
| 82950 |
|
12 |
12 |
$66.44 |
| 90686 |
|
20 |
18 |
$0.00 |
| 90619 |
|
25 |
25 |
$0.00 |
| 90734 |
|
19 |
16 |
$0.00 |
| 90715 |
|
14 |
14 |
$0.00 |
| 0502F |
|
15 |
15 |
$0.00 |