| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,293 |
4,185 |
$116K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,436 |
1,879 |
$67K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
161 |
161 |
$12K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
666 |
658 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
44 |
44 |
$3K |
| 90686 |
|
760 |
722 |
$3K |
| 90688 |
|
249 |
232 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
48 |
24 |
$625.38 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
31 |
26 |
$624.96 |
| 90656 |
|
23 |
23 |
$193.41 |
| 90658 |
|
15 |
15 |
$181.44 |
| 36415 |
Collection of venous blood by venipuncture |
2,019 |
1,395 |
$45.55 |
| 90756 |
|
21 |
21 |
$22.79 |
| 3008F |
|
870 |
846 |
$0.00 |
| 3079F |
|
237 |
234 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
351 |
314 |
$0.00 |
| 3074F |
|
290 |
281 |
$0.00 |
| 3075F |
|
28 |
28 |
$0.00 |
| 1170F |
|
100 |
100 |
$0.00 |
| 90651 |
|
25 |
25 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
32 |
32 |
$0.00 |
| 1126F |
|
14 |
14 |
$0.00 |
| 1159F |
|
53 |
52 |
$0.00 |
| 3077F |
|
98 |
95 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
28 |
27 |
$0.00 |
| 3078F |
|
274 |
263 |
$0.00 |
| 2028F |
|
15 |
15 |
$0.00 |
| 3288F |
|
28 |
28 |
$0.00 |