| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,670 |
9,915 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,067 |
2,933 |
$4K |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
187 |
185 |
$3K |
| 99442 |
|
4,129 |
3,826 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
526 |
518 |
$2K |
| 92552 |
|
243 |
243 |
$1K |
| 90715 |
|
75 |
75 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
419 |
416 |
$760.90 |
| 93000 |
|
63 |
62 |
$718.48 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
272 |
271 |
$551.48 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
159 |
159 |
$534.40 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
184 |
181 |
$372.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
75 |
74 |
$317.79 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
629 |
607 |
$214.41 |
| 99441 |
|
753 |
725 |
$214.30 |
| 94760 |
|
5,404 |
4,768 |
$187.45 |
| 99215 |
Prolong outpt/office vis |
22 |
20 |
$169.89 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
25 |
25 |
$85.82 |
| 90686 |
|
29 |
29 |
$42.00 |
| 81002 |
|
13 |
13 |
$2.13 |
| 3074F |
|
94 |
91 |
$0.00 |
| 99172 |
|
221 |
221 |
$0.00 |
| 3075F |
|
15 |
15 |
$0.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$0.00 |
| 3044F |
|
90 |
90 |
$0.00 |
| 99443 |
|
13 |
13 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
25 |
25 |
$0.00 |
| 3079F |
|
16 |
16 |
$0.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
28 |
28 |
$0.00 |
| 3078F |
|
70 |
68 |
$0.00 |
| G9920 |
Screening performed and negative |
194 |
193 |
$0.00 |
| G9919 |
Screening performed and positive and provision of recommendations |
151 |
150 |
$0.00 |
| A4550 |
Surgical trays |
31 |
31 |
$0.00 |
| 99397 |
|
50 |
44 |
$0.00 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
28 |
28 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
14 |
14 |
$0.00 |