| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,189 |
5,777 |
$136K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,774 |
2,390 |
$87K |
| 90688 |
|
317 |
279 |
$2K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
187 |
160 |
$1K |
| 99496 |
|
27 |
25 |
$875.99 |
| G0008 |
Administration of influenza virus vaccine |
193 |
175 |
$714.29 |
| 99406 |
|
49 |
43 |
$252.40 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
24 |
20 |
$127.17 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
51 |
50 |
$73.87 |
| 86580 |
|
32 |
25 |
$73.56 |
| 99072 |
|
20 |
17 |
$18.03 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
53 |
46 |
$14.91 |
| 3008F |
|
7,318 |
5,825 |
$2.74 |
| 3078F |
|
1,706 |
1,419 |
$0.92 |
| 3077F |
|
1,093 |
897 |
$0.72 |
| 3074F |
|
1,117 |
968 |
$0.52 |
| 3079F |
|
629 |
559 |
$0.37 |
| 3075F |
|
297 |
262 |
$0.25 |
| 1170F |
|
256 |
215 |
$0.23 |
| 1160F |
|
248 |
215 |
$0.19 |
| 1159F |
|
247 |
213 |
$0.19 |
| 3080F |
|
89 |
80 |
$0.12 |
| G0406 |
Follow-up inpatient consultation, limited, physicians typically spend 15 minutes communicating with the patient via telehealth |
87 |
72 |
$0.08 |
| 1125F |
|
91 |
81 |
$0.06 |
| 3725F |
|
299 |
261 |
$0.06 |
| 4010F |
|
76 |
73 |
$0.05 |
| 2000F |
|
8,041 |
6,346 |
$0.04 |
| 3066F |
|
51 |
51 |
$0.04 |
| 1111F |
|
48 |
40 |
$0.02 |
| 1126F |
|
13 |
13 |
$0.01 |
| 1036F |
|
146 |
139 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
601 |
549 |
$0.00 |
| G9275 |
Documentation that patient is a current non-tobacco user |
35 |
35 |
$0.00 |
| 1101F |
|
100 |
92 |
$0.00 |
| S9999 |
Sales tax |
351 |
271 |
$0.00 |
| 1494F |
|
73 |
67 |
$0.00 |