| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99349 |
|
1,412 |
1,226 |
$48K |
| 99442 |
|
1,178 |
1,063 |
$33K |
| 99348 |
|
1,250 |
921 |
$33K |
| 99443 |
|
891 |
730 |
$31K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
184 |
158 |
$6K |
| 99490 |
Ccm add 20min |
356 |
352 |
$4K |
| 99350 |
Prolong home eval add 15m |
67 |
66 |
$3K |
| 99347 |
|
215 |
169 |
$3K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
391 |
347 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
26 |
26 |
$1K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
32 |
32 |
$805.32 |
| 99441 |
|
54 |
43 |
$716.90 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
17 |
17 |
$658.55 |
| 99343 |
|
13 |
13 |
$549.50 |
| 99497 |
|
32 |
32 |
$468.09 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$375.42 |
| 3078F |
|
155 |
152 |
$2.12 |
| 3074F |
|
127 |
121 |
$2.12 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
16 |
16 |
$0.00 |
| 1159F |
|
137 |
126 |
$0.00 |
| 1160F |
|
108 |
97 |
$0.00 |
| 3077F |
|
120 |
115 |
$0.00 |
| 1126F |
|
212 |
207 |
$0.00 |
| 1125F |
|
143 |
139 |
$0.00 |
| 1170F |
|
28 |
28 |
$0.00 |
| 1157F |
|
32 |
32 |
$0.00 |
| 3079F |
|
80 |
78 |
$0.00 |
| 3080F |
|
52 |
51 |
$0.00 |
| 3075F |
|
40 |
40 |
$0.00 |