| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
10,370 |
8,597 |
$604K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,130 |
2,715 |
$129K |
| 99215 |
Prolong outpt/office vis |
364 |
327 |
$35K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
184 |
177 |
$19K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
191 |
171 |
$12K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
786 |
513 |
$4K |
| 93000 |
|
378 |
336 |
$3K |
| 90756 |
|
180 |
154 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
46 |
41 |
$2K |
| 90688 |
|
729 |
466 |
$2K |
| 99442 |
|
22 |
22 |
$612.84 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
14 |
14 |
$233.14 |
| 0011A |
|
13 |
12 |
$118.89 |
| 90661 |
|
13 |
13 |
$112.00 |
| 99499 |
|
14 |
13 |
$103.00 |
| 96127 |
|
19 |
14 |
$47.28 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
166 |
132 |
$33.78 |
| 1160F |
|
353 |
327 |
$25.00 |
| 81002 |
|
52 |
46 |
$14.64 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
54 |
40 |
$6.48 |
| G0008 |
Administration of influenza virus vaccine |
52 |
49 |
$0.00 |
| 3074F |
|
621 |
553 |
$0.00 |
| 3079F |
|
186 |
172 |
$0.00 |
| 3044F |
|
174 |
150 |
$0.00 |
| 3008F |
|
324 |
314 |
$0.00 |
| 3075F |
|
36 |
36 |
$0.00 |
| 99172 |
|
47 |
42 |
$0.00 |
| 3078F |
|
353 |
313 |
$0.00 |
| 1159F |
|
319 |
302 |
$0.00 |