| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,747 |
5,001 |
$186K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
738 |
600 |
$17K |
| 99397 |
|
194 |
182 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
201 |
191 |
$2K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
151 |
148 |
$2K |
| 90658 |
|
77 |
76 |
$1K |
| 90688 |
|
239 |
232 |
$1K |
| 90686 |
|
57 |
55 |
$887.84 |
| G0008 |
Administration of influenza virus vaccine |
252 |
209 |
$64.85 |
| 90630 |
|
39 |
37 |
$54.60 |
| 90694 |
|
18 |
15 |
$42.90 |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
200 |
172 |
$8.00 |
| 3078F |
|
273 |
227 |
$0.00 |
| 1160F |
|
381 |
362 |
$0.00 |
| 1159F |
|
312 |
306 |
$0.00 |
| 3008F |
|
354 |
250 |
$0.00 |
| 3074F |
|
119 |
89 |
$0.00 |
| 1170F |
|
47 |
47 |
$0.00 |
| 1126F |
|
18 |
18 |
$0.00 |
| 1157F |
|
12 |
12 |
$0.00 |