| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,466 |
3,766 |
$104K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,996 |
4,059 |
$39K |
| 99205 |
Prolong outpt/office vis |
12 |
12 |
$559.21 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
239 |
236 |
$353.59 |
| 99497 |
|
296 |
293 |
$126.14 |
| 90686 |
|
52 |
52 |
$21.50 |
| 96127 |
|
161 |
155 |
$18.10 |
| G0008 |
Administration of influenza virus vaccine |
126 |
126 |
$12.63 |
| 1159F |
|
594 |
578 |
$0.00 |
| 3078F |
|
578 |
560 |
$0.00 |
| 1160F |
|
594 |
578 |
$0.00 |
| 3095F |
|
163 |
162 |
$0.00 |
| 99397 |
|
276 |
275 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
71 |
67 |
$0.00 |
| 4274F |
|
89 |
82 |
$0.00 |
| 4040F |
|
118 |
112 |
$0.00 |
| G9275 |
Documentation that patient is a current non-tobacco user |
635 |
632 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
12 |
12 |
$0.00 |
| 1157F |
|
444 |
441 |
$0.00 |
| 1101F |
|
611 |
593 |
$0.00 |
| 3075F |
|
253 |
250 |
$0.00 |
| 3044F |
|
105 |
99 |
$0.00 |
| 3008F |
|
1,304 |
1,273 |
$0.00 |
| 3014F |
|
258 |
254 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,540 |
1,501 |
$0.00 |
| 1125F |
|
138 |
134 |
$0.00 |
| 3074F |
|
359 |
348 |
$0.00 |
| 1170F |
|
603 |
585 |
$0.00 |
| 3061F |
|
61 |
57 |
$0.00 |
| 3017F |
|
431 |
419 |
$0.00 |
| 1126F |
|
341 |
329 |
$0.00 |
| Q2035 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria) |
28 |
28 |
$0.00 |
| 3079F |
|
79 |
79 |
$0.00 |
| Q2036 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (flulaval) |
44 |
44 |
$0.00 |