| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,104 |
5,257 |
$321K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,104 |
3,711 |
$162K |
| 95117 |
|
1,468 |
468 |
$11K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
30 |
25 |
$9K |
| V5008 |
Hearing screening |
251 |
198 |
$5K |
| 90688 |
|
230 |
182 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
1,527 |
1,125 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
19 |
15 |
$1K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
90 |
61 |
$490.81 |
| 99173 |
|
251 |
198 |
$479.32 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
37 |
25 |
$472.07 |
| 94060 |
|
18 |
13 |
$335.26 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
514 |
369 |
$316.08 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
28 |
13 |
$253.96 |
| 90662 |
|
133 |
92 |
$234.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$169.68 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
22 |
13 |
$125.95 |
| 3078F |
|
47 |
40 |
$108.75 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
58 |
41 |
$86.32 |
| 3074F |
|
17 |
14 |
$77.50 |
| 99000 |
|
29 |
26 |
$59.79 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
62 |
39 |
$42.10 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
164 |
113 |
$38.75 |
| 96127 |
|
14 |
14 |
$29.20 |
| G0008 |
Administration of influenza virus vaccine |
134 |
92 |
$20.00 |
| 3725F |
|
18 |
18 |
$10.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
15 |
14 |
$3.40 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
76 |
56 |
$0.00 |
| 1101F |
|
27 |
14 |
$0.00 |
| 3008F |
|
80 |
67 |
$0.00 |
| 1000F |
|
12 |
12 |
$0.00 |
| G8839 |
Sleep apnea symptoms assessed, including presence or absence of snoring and daytime sleepiness |
21 |
14 |
$0.00 |
| A4617 |
Mouth piece |
19 |
13 |
$0.00 |
| 3288F |
|
27 |
14 |
$0.00 |
| 1100F |
|
27 |
14 |
$0.00 |