| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,050 |
701 |
$116K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,192 |
1,969 |
$23K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
40 |
40 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
211 |
203 |
$2K |
| 99442 |
|
50 |
48 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
245 |
244 |
$652.80 |
| S9445 |
Patient education, not otherwise classified, non-physician provider, individual, per session |
44 |
44 |
$416.58 |
| A4267 |
Contraceptive supply, condom, male, each |
36 |
36 |
$362.88 |
| 99000 |
|
43 |
43 |
$116.96 |
| 99458 |
|
12 |
12 |
$70.84 |
| 99457 |
|
12 |
12 |
$70.84 |
| 81025 |
|
12 |
12 |
$33.60 |
| 1170F |
|
55 |
54 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
14 |
14 |
$0.00 |
| 1159F |
|
56 |
56 |
$0.00 |
| 1160F |
|
58 |
57 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
28 |
28 |
$0.00 |