| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20,284 |
13,813 |
$868K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,693 |
3,875 |
$278K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
407 |
398 |
$39K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
133 |
121 |
$11K |
| 99397 |
|
315 |
267 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
691 |
572 |
$7K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
239 |
219 |
$7K |
| 93922 |
|
93 |
86 |
$4K |
| 90688 |
|
454 |
400 |
$4K |
| 90686 |
|
394 |
382 |
$4K |
| 93015 |
|
62 |
55 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
31 |
31 |
$2K |
| 93000 |
|
121 |
110 |
$2K |
| 94010 |
|
34 |
29 |
$542.65 |
| G0008 |
Administration of influenza virus vaccine |
291 |
270 |
$371.78 |
| 90658 |
|
23 |
23 |
$333.44 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$114.79 |
| S9999 |
Sales tax |
1,019 |
593 |
$36.06 |
| 3078F |
|
1,861 |
1,596 |
$1.45 |
| 3074F |
|
1,820 |
1,580 |
$1.42 |
| 1170F |
|
1,106 |
978 |
$0.74 |
| 1125F |
|
287 |
203 |
$0.33 |
| 3044F |
|
546 |
501 |
$0.27 |
| 1160F |
|
1,233 |
1,086 |
$0.26 |
| 1159F |
|
343 |
271 |
$0.04 |
| 1126F |
|
611 |
570 |
$0.03 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
287 |
269 |
$0.00 |
| 1111F |
|
165 |
155 |
$0.00 |