| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99454 |
|
7,191 |
7,082 |
$98K |
| 99457 |
|
7,260 |
7,034 |
$80K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,622 |
1,356 |
$67K |
| 99490 |
Ccm add 20min |
3,409 |
3,389 |
$46K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
177 |
170 |
$17K |
| 99401 |
|
694 |
576 |
$16K |
| 99458 |
|
760 |
750 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
55 |
51 |
$4K |
| 99497 |
|
169 |
156 |
$1K |
| 99407 |
|
164 |
137 |
$815.98 |
| 99453 |
|
98 |
98 |
$811.44 |
| 99402 |
|
443 |
381 |
$790.72 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
49 |
49 |
$720.02 |
| 90674 |
|
26 |
26 |
$364.58 |
| 99487 |
Ccm add 20min |
12 |
12 |
$206.80 |
| 90756 |
|
14 |
14 |
$164.16 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
320 |
277 |
$90.14 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
13 |
13 |
$77.84 |
| 36415 |
Collection of venous blood by venipuncture |
401 |
366 |
$53.67 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
30 |
29 |
$15.54 |
| 93000 |
|
24 |
19 |
$7.00 |
| 99383 |
|
15 |
15 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
74 |
74 |
$0.00 |