| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,598 |
1,520 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,084 |
1,045 |
$4K |
| 93000 |
|
666 |
665 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
300 |
300 |
$605.40 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
235 |
227 |
$229.91 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
12 |
12 |
$200.00 |
| 99307 |
|
52 |
52 |
$147.96 |
| 1101F |
|
262 |
261 |
$130.00 |
| 96127 |
|
101 |
101 |
$12.00 |
| 3078F |
|
3,623 |
3,431 |
$11.10 |
| 3074F |
|
3,068 |
2,914 |
$9.30 |
| 99442 |
|
24 |
24 |
$5.00 |
| 4013F |
|
1,335 |
1,290 |
$4.80 |
| 3008F |
|
1,092 |
1,086 |
$3.00 |
| 3044F |
|
851 |
847 |
$3.00 |
| 1159F |
|
1,150 |
1,145 |
$3.00 |
| 1160F |
|
1,138 |
1,133 |
$3.00 |
| 3048F |
|
667 |
663 |
$1.80 |
| 3075F |
|
416 |
401 |
$1.80 |
| 1125F |
|
27 |
27 |
$0.90 |
| 3061F |
|
67 |
67 |
$0.90 |
| 3725F |
|
303 |
301 |
$0.90 |
| 1170F |
|
271 |
270 |
$0.30 |
| 3288F |
|
83 |
83 |
$0.30 |
| 1003F |
|
72 |
72 |
$0.30 |
| 96151 |
|
130 |
130 |
$0.04 |
| 1126F |
|
207 |
205 |
$0.00 |
| 90688 |
|
14 |
14 |
$0.00 |
| 99441 |
|
12 |
12 |
$0.00 |
| 3079F |
|
29 |
29 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$0.00 |
| 96156 |
|
13 |
13 |
$0.00 |
| 1090F |
|
178 |
177 |
$0.00 |
| 99397 |
|
12 |
12 |
$0.00 |
| 90749 |
|
16 |
16 |
$0.00 |