| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,675 |
3,815 |
$118K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,769 |
2,909 |
$47K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
343 |
310 |
$722.78 |
| S9999 |
Sales tax |
1,162 |
795 |
$107.78 |
| G0008 |
Administration of influenza virus vaccine |
80 |
66 |
$47.90 |
| 90688 |
|
16 |
14 |
$17.84 |
| 1101F |
|
374 |
335 |
$0.00 |
| 3008F |
|
1,944 |
1,621 |
$0.00 |
| 1170F |
|
388 |
347 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
293 |
262 |
$0.00 |
| 1157F |
|
366 |
320 |
$0.00 |
| 1036F |
|
436 |
384 |
$0.00 |
| 1125F |
|
374 |
333 |
$0.00 |
| 99406 |
|
75 |
68 |
$0.00 |
| G9275 |
Documentation that patient is a current non-tobacco user |
30 |
28 |
$0.00 |
| 3074F |
|
124 |
103 |
$0.00 |
| 3075F |
|
371 |
317 |
$0.00 |
| 1126F |
|
339 |
307 |
$0.00 |
| 3079F |
|
153 |
128 |
$0.00 |
| 3080F |
|
131 |
107 |
$0.00 |
| 1100F |
|
321 |
289 |
$0.00 |
| 1159F |
|
367 |
329 |
$0.00 |
| 1158F |
|
130 |
120 |
$0.00 |
| 1160F |
|
366 |
328 |
$0.00 |
| 3078F |
|
376 |
322 |
$0.00 |
| Q2038 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (fluzone) |
134 |
118 |
$0.00 |
| 3077F |
|
116 |
94 |
$0.00 |