| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,052 |
4,573 |
$28K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,926 |
1,902 |
$16K |
| 90686 |
|
350 |
349 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
595 |
583 |
$2K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
342 |
341 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,069 |
1,066 |
$1K |
| 90688 |
|
86 |
86 |
$1K |
| 88150 |
|
35 |
35 |
$471.40 |
| 90662 |
|
45 |
45 |
$300.00 |
| 90756 |
|
27 |
27 |
$280.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,762 |
1,760 |
$220.01 |
| 99443 |
|
38 |
36 |
$168.48 |
| 1158F |
|
14 |
14 |
$82.36 |
| 3074F |
|
1,384 |
1,381 |
$80.00 |
| 3008F |
|
2,113 |
2,106 |
$35.00 |
| 3078F |
|
1,606 |
1,603 |
$35.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
13 |
13 |
$21.01 |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
101 |
101 |
$20.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
37 |
37 |
$0.02 |
| 3075F |
|
131 |
131 |
$0.00 |
| 1126F |
|
437 |
437 |
$0.00 |
| 3014F |
|
258 |
252 |
$0.00 |
| 1101F |
|
433 |
433 |
$0.00 |
| 3017F |
|
312 |
305 |
$0.00 |
| 1170F |
|
430 |
430 |
$0.00 |
| 1157F |
|
25 |
25 |
$0.00 |
| 3079F |
|
128 |
128 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
61 |
61 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
143 |
143 |
$0.00 |
| 1159F |
|
527 |
527 |
$0.00 |
| 1090F |
|
336 |
336 |
$0.00 |
| 1160F |
|
523 |
523 |
$0.00 |
| 3077F |
|
44 |
43 |
$0.00 |
| 3288F |
|
14 |
14 |
$0.00 |