| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,533 |
2,461 |
$82K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,734 |
1,525 |
$36K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
98 |
98 |
$5K |
| 90653 |
|
52 |
52 |
$584.43 |
| 3078F |
|
206 |
200 |
$350.00 |
| 90694 |
|
222 |
221 |
$284.86 |
| 90674 |
|
114 |
114 |
$175.35 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
34 |
34 |
$108.68 |
| 90688 |
|
90 |
90 |
$91.34 |
| 3062F |
|
12 |
12 |
$0.00 |
| 90658 |
|
12 |
12 |
$0.00 |
| 90756 |
|
37 |
37 |
$0.00 |
| 4010F |
|
365 |
354 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
569 |
569 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
286 |
286 |
$0.00 |
| 3074F |
|
84 |
82 |
$0.00 |
| 1157F |
|
27 |
25 |
$0.00 |
| 3066F |
|
96 |
94 |
$0.00 |