| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,251 |
1,795 |
$111K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,017 |
1,679 |
$70K |
| 99497 |
|
716 |
667 |
$19K |
| 99406 |
|
1,388 |
1,029 |
$9K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
125 |
122 |
$7K |
| 96127 |
|
2,322 |
2,090 |
$5K |
| 99443 |
|
137 |
117 |
$5K |
| 93000 |
|
436 |
393 |
$4K |
| 94010 |
|
216 |
172 |
$4K |
| 99442 |
|
133 |
111 |
$3K |
| 94760 |
|
4,701 |
3,497 |
$2K |
| 81002 |
|
969 |
861 |
$2K |
| 94375 |
|
56 |
46 |
$1K |
| 1036F |
|
2,452 |
1,913 |
$949.49 |
| 90688 |
|
96 |
94 |
$855.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
16 |
12 |
$816.32 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
26 |
24 |
$800.62 |
| 99072 |
|
116 |
87 |
$602.79 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
33 |
32 |
$435.62 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
26 |
24 |
$400.99 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
55 |
55 |
$328.45 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
22 |
20 |
$128.59 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,341 |
1,034 |
$120.01 |
| G0008 |
Administration of influenza virus vaccine |
14 |
14 |
$58.03 |
| 1160F |
|
351 |
242 |
$0.19 |
| 1170F |
|
69 |
51 |
$0.07 |
| 1159F |
|
101 |
71 |
$0.07 |
| 1125F |
|
19 |
12 |
$0.02 |
| 3078F |
|
19 |
13 |
$0.01 |
| 3017F |
|
138 |
114 |
$0.00 |
| 3008F |
|
32 |
28 |
$0.00 |
| 1157F |
|
34 |
33 |
$0.00 |
| 1123F |
|
14 |
13 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
1,657 |
1,242 |
$0.00 |
| 4040F |
|
203 |
174 |
$0.00 |
| 1158F |
|
31 |
30 |
$0.00 |
| 1124F |
|
16 |
16 |
$0.00 |