| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,705 |
2,573 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,656 |
3,487 |
$5K |
| 90686 |
|
80 |
79 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
105 |
105 |
$915.90 |
| 90682 |
|
25 |
25 |
$884.25 |
| 3008F |
|
1,526 |
1,526 |
$218.26 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
682 |
682 |
$157.73 |
| 3078F |
|
2,559 |
2,486 |
$149.22 |
| 3077F |
|
1,643 |
1,607 |
$147.56 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
60 |
60 |
$143.32 |
| 90688 |
|
41 |
41 |
$136.34 |
| 99215 |
Prolong outpt/office vis |
104 |
104 |
$113.26 |
| 3074F |
|
2,532 |
2,459 |
$105.83 |
| 36415 |
Collection of venous blood by venipuncture |
383 |
379 |
$95.61 |
| 3075F |
|
871 |
861 |
$92.95 |
| 3080F |
|
658 |
642 |
$37.49 |
| 3079F |
|
1,597 |
1,564 |
$0.00 |
| 1170F |
|
543 |
543 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
451 |
451 |
$0.00 |
| 1111F |
|
14 |
13 |
$0.00 |
| 3725F |
|
474 |
474 |
$0.00 |
| 1159F |
|
97 |
95 |
$0.00 |
| 4004F |
|
516 |
516 |
$0.00 |
| 3288F |
|
479 |
479 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
12 |
$0.00 |
| 1160F |
|
16 |
15 |
$0.00 |