| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
12,006 |
9,266 |
$277K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
218 |
201 |
$36K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
205 |
205 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
39 |
39 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
29 |
21 |
$5K |
| 90654 |
|
869 |
857 |
$3K |
| Q3014 |
Telehealth originating site facility fee |
1,737 |
1,476 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
881 |
865 |
$2K |
| 90834 |
Psychotherapy, 45 minutes with patient |
109 |
70 |
$730.77 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
15 |
14 |
$137.47 |
| 81025 |
|
14 |
13 |
$91.28 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
55 |
55 |
$48.79 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
16 |
16 |
$13.25 |
| 91301 |
|
28 |
28 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
416 |
412 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,123 |
959 |
$0.00 |
| 0001A |
|
223 |
223 |
$0.00 |
| 0064A |
|
21 |
18 |
$0.00 |
| 0011A |
|
80 |
80 |
$0.00 |
| 0012A |
|
77 |
77 |
$0.00 |
| 90480 |
|
80 |
77 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
102 |
99 |
$0.00 |
| 0004A |
|
53 |
52 |
$0.00 |
| 0124A |
|
84 |
82 |
$0.00 |
| 0054A |
|
57 |
57 |
$0.00 |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
12 |
12 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
13 |
13 |
$0.00 |
| 91320 |
|
73 |
70 |
$0.00 |
| 85610 |
|
37 |
25 |
$0.00 |
| 0002A |
|
211 |
211 |
$0.00 |
| 81003 |
|
15 |
14 |
$0.00 |
| 91300 |
|
38 |
38 |
$0.00 |