| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,353 |
3,511 |
$211K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,429 |
3,175 |
$141K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
52 |
46 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
453 |
373 |
$5K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
34 |
34 |
$2K |
| 90688 |
|
222 |
155 |
$2K |
| 90686 |
|
147 |
146 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
39 |
35 |
$1K |
| 99497 |
|
40 |
32 |
$982.32 |
| 91320 |
|
27 |
27 |
$650.12 |
| 90658 |
|
64 |
58 |
$643.38 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
97 |
92 |
$480.84 |
| 90756 |
|
23 |
22 |
$385.20 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
81 |
81 |
$199.89 |
| 90480 |
|
27 |
27 |
$192.28 |
| 96380 |
|
40 |
33 |
$161.13 |
| 96127 |
|
51 |
45 |
$147.16 |
| 99397 |
|
34 |
34 |
$81.96 |
| 96116 |
|
13 |
13 |
$66.56 |
| G0008 |
Administration of influenza virus vaccine |
135 |
134 |
$64.53 |
| G0009 |
Administration of pneumococcal vaccine |
13 |
12 |
$0.90 |
| 3078F |
|
670 |
455 |
$0.30 |
| 3074F |
|
626 |
450 |
$0.27 |
| 3077F |
|
159 |
135 |
$0.09 |
| 3075F |
|
181 |
160 |
$0.07 |
| 3079F |
|
138 |
124 |
$0.06 |
| 3080F |
|
32 |
28 |
$0.02 |
| 1170F |
|
213 |
171 |
$0.00 |
| 1126F |
|
42 |
41 |
$0.00 |
| 1125F |
|
135 |
108 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
15 |
13 |
$0.00 |
| 1100F |
|
267 |
225 |
$0.00 |
| 1159F |
|
212 |
166 |
$0.00 |
| S9999 |
Sales tax |
170 |
112 |
$0.00 |
| 1160F |
|
203 |
160 |
$0.00 |
| 3288F |
|
14 |
13 |
$0.00 |