| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
|
14,110 |
13,605 |
$101K |
| 43239 |
|
602 |
594 |
$87K |
| 99204 |
|
1,437 |
1,426 |
$61K |
| G0442 |
Annual alcohol screen 15 min |
2,654 |
2,649 |
$43K |
| 99335 |
|
1,344 |
827 |
$38K |
| 90674 |
|
907 |
904 |
$21K |
| 99215 |
Prolong outpt/office vis |
1,922 |
1,885 |
$15K |
| 45378 |
|
126 |
126 |
$14K |
| 99213 |
|
3,279 |
3,150 |
$13K |
| 99443 |
|
242 |
234 |
$10K |
| 99348 |
|
523 |
382 |
$10K |
| 99153 |
Mod sedat endo service >5yrs |
651 |
648 |
$5K |
| 45380 |
|
27 |
27 |
$4K |
| 99308 |
|
355 |
190 |
$4K |
| 99309 |
|
234 |
161 |
$4K |
| 99496 |
|
139 |
133 |
$3K |
| 90661 |
|
79 |
79 |
$2K |
| 99152 |
|
308 |
305 |
$2K |
| 90658 |
|
91 |
91 |
$2K |
| 96372 |
|
429 |
417 |
$1K |
| 99442 |
|
29 |
29 |
$1K |
| 99334 |
|
93 |
80 |
$1K |
| G0008 |
Admin influenza virus vac |
131 |
131 |
$953.12 |
| 99347 |
|
126 |
104 |
$953.04 |
| 3075F |
|
460 |
460 |
$600.00 |
| J3420 |
Vitamin b12 injection |
273 |
266 |
$299.27 |
| 90471 |
|
823 |
818 |
$223.75 |
| Q2035 |
Afluria vacc, 3 yrs & >, im |
16 |
16 |
$203.16 |
| 3078F |
|
1,630 |
1,625 |
$200.00 |
| G9920 |
Scrning perf and negative |
1,669 |
1,667 |
$194.42 |
| G8510 |
Scr dep neg, no plan reqd |
1,711 |
1,710 |
$179.59 |
| 3074F |
|
1,391 |
1,391 |
$100.00 |
| 3079F |
|
294 |
294 |
$100.00 |
| G0444 |
Depression screen annual |
391 |
372 |
$35.33 |
| 1111F |
|
306 |
300 |
$3.00 |
| G8431 |
Pos clin depres scrn f/u doc |
172 |
168 |
$2.88 |
| 4004F |
|
924 |
922 |
$1.00 |
| G9919 |
Scrn nd pos nd prov of rec |
187 |
187 |
$0.00 |
| 99396 |
|
12 |
12 |
$0.00 |
| 4450F |
|
12 |
12 |
$0.00 |
| 1220F |
|
165 |
164 |
$0.00 |