| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,959 |
8,693 |
$327K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,689 |
2,643 |
$97K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
203 |
203 |
$19K |
| 90688 |
|
886 |
881 |
$12K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
858 |
846 |
$8K |
| 36415 |
Collection of venous blood by venipuncture |
2,147 |
2,120 |
$4K |
| 90756 |
|
204 |
201 |
$2K |
| 90658 |
|
56 |
56 |
$2K |
| 0013A |
|
42 |
42 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
14 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
103 |
103 |
$1K |
| 0012A |
|
31 |
31 |
$880.00 |
| 0011A |
|
32 |
32 |
$745.22 |
| 90656 |
|
34 |
33 |
$586.50 |
| 90686 |
|
59 |
59 |
$565.32 |
| 0134A |
|
17 |
17 |
$560.00 |
| 0003A |
|
12 |
12 |
$480.00 |
| G0008 |
Administration of influenza virus vaccine |
436 |
430 |
$0.00 |
| 91301 |
|
140 |
139 |
$0.00 |
| Q2035 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria) |
22 |
22 |
$0.00 |
| 91300 |
|
34 |
32 |
$0.00 |
| 91313 |
|
17 |
17 |
$0.00 |