| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
785 |
664 |
$93K |
| 99397 |
|
33 |
27 |
$9K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
18 |
13 |
$4K |
| 90674 |
|
61 |
61 |
$2K |
| 96150 |
|
86 |
61 |
$1K |
| S3005 |
Performance measurement, evaluation of patient self assessment, depression |
67 |
60 |
$945.00 |
| A4550 |
Surgical trays |
28 |
27 |
$759.00 |
| 96156 |
|
18 |
15 |
$270.00 |
| 82962 |
|
12 |
12 |
$96.00 |
| 3074F |
|
40 |
28 |
$0.00 |
| 1170F |
|
51 |
40 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
60 |
60 |
$0.00 |
| 3008F |
|
116 |
87 |
$0.00 |
| 1000F |
|
49 |
39 |
$0.00 |
| 1036F |
|
16 |
13 |
$0.00 |
| 1126F |
|
15 |
12 |
$0.00 |
| 1101F |
|
33 |
27 |
$0.00 |
| 3078F |
|
78 |
60 |
$0.00 |
| 99051 |
|
67 |
59 |
$0.00 |
| 3725F |
|
133 |
110 |
$0.00 |
| 1159F |
|
53 |
41 |
$0.00 |
| 1160F |
|
53 |
41 |
$0.00 |
| 0521F |
|
33 |
27 |
$0.00 |
| 1158F |
|
33 |
27 |
$0.00 |
| 4004F |
|
51 |
40 |
$0.00 |
| 1090F |
|
51 |
40 |
$0.00 |