| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,408 |
5,420 |
$273K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,451 |
1,390 |
$89K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
317 |
317 |
$24K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
82 |
13 |
$20K |
| 93923 |
|
136 |
102 |
$13K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
168 |
168 |
$12K |
| 95923 |
|
134 |
132 |
$10K |
| 90674 |
|
246 |
244 |
$6K |
| 95921 |
|
133 |
132 |
$6K |
| 0011A |
|
133 |
133 |
$3K |
| 0012A |
|
106 |
105 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
302 |
299 |
$2K |
| 99335 |
|
17 |
14 |
$953.10 |
| 90656 |
|
55 |
55 |
$907.69 |
| 0031A |
|
23 |
23 |
$718.90 |
| 99334 |
|
20 |
20 |
$283.30 |
| 92250 |
|
29 |
17 |
$282.84 |
| G0008 |
Administration of influenza virus vaccine |
15 |
15 |
$0.00 |
| 91301 |
|
238 |
233 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
12 |
12 |
$0.00 |
| 91303 |
|
18 |
18 |
$0.00 |