| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,061 |
4,220 |
$383K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
692 |
615 |
$34K |
| 99215 |
Prolong outpt/office vis |
267 |
263 |
$32K |
| 99406 |
|
2,347 |
1,949 |
$28K |
| 93306 |
Echocardiography, transthoracic, real-time with image documentation, with and without Doppler, complete |
124 |
124 |
$18K |
| 94375 |
|
479 |
470 |
$13K |
| 99199 |
Unlisted special service, procedure or report |
1,388 |
929 |
$12K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
105 |
103 |
$10K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
81 |
79 |
$9K |
| 80305 |
|
325 |
316 |
$4K |
| 96127 |
|
741 |
658 |
$3K |
| 81002 |
|
1,034 |
947 |
$3K |
| 93000 |
|
149 |
148 |
$2K |
| 94664 |
|
183 |
180 |
$2K |
| 76705 |
Ultrasound, abdominal, real time with image documentation; limited |
40 |
39 |
$558.17 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
34 |
34 |
$425.60 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
27 |
25 |
$372.54 |
| 99441 |
|
13 |
12 |
$324.30 |
| 90686 |
|
38 |
18 |
$297.90 |
| 90688 |
|
91 |
36 |
$245.25 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24 |
12 |
$169.56 |
| G0403 |
Electrocardiogram, routine ecg with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report |
43 |
41 |
$47.26 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
14 |
14 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
59 |
57 |
$0.00 |
| 99497 |
|
41 |
41 |
$0.00 |