| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99336 |
|
11,615 |
8,270 |
$264K |
| 99349 |
|
10,969 |
6,820 |
$211K |
| 99350 |
Prolong home eval add 15m |
1,300 |
846 |
$34K |
| 99401 |
|
11,677 |
9,026 |
$29K |
| 99337 |
|
775 |
593 |
$28K |
| 99395 |
|
573 |
309 |
$5K |
| 99396 |
|
243 |
135 |
$1K |
| 99214 |
|
108 |
67 |
$1K |
| 90792 |
|
80 |
44 |
$1K |
| 69210 |
|
110 |
89 |
$1K |
| 86580 |
|
1,710 |
941 |
$803.55 |
| 96372 |
|
813 |
626 |
$644.09 |
| 99328 |
|
32 |
13 |
$532.95 |
| 99487 |
Ccm add 20min |
280 |
220 |
$449.35 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
1,325 |
882 |
$365.78 |
| 99490 |
Ccm add 20min |
854 |
704 |
$316.32 |
| 99334 |
|
53 |
38 |
$305.51 |
| 99491 |
Ccm add 20min |
512 |
401 |
$261.61 |
| 90791 |
|
33 |
16 |
$234.36 |
| G0506 |
Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to primary monthly care management service) |
446 |
292 |
$91.00 |
| 90833 |
|
440 |
300 |
$28.14 |
| J0401 |
Injection, aripiprazole (abilify maintena), 1 mg |
148 |
130 |
$12.34 |
| 99406 |
|
67 |
44 |
$10.39 |
| G0008 |
Administration of influenza virus vaccine |
281 |
220 |
$8.00 |
| 96127 |
|
3,964 |
3,034 |
$1.82 |
| 0518F |
|
597 |
485 |
$0.00 |
| 0580F |
|
62 |
41 |
$0.00 |
| 2028F |
|
63 |
52 |
$0.00 |
| 2018F |
|
73 |
59 |
$0.00 |
| 90674 |
|
193 |
180 |
$0.00 |
| 1126F |
|
505 |
410 |
$0.00 |
| 90688 |
|
28 |
14 |
$0.00 |
| 1157F |
|
71 |
53 |
$0.00 |
| Q2035 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria) |
76 |
35 |
$0.00 |