| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,645 |
8,534 |
$827K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
2,244 |
2,244 |
$292K |
| 90756 |
|
1,527 |
1,526 |
$43K |
| 93000 |
|
2,235 |
2,235 |
$30K |
| 99442 |
|
362 |
346 |
$22K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,346 |
1,335 |
$22K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
134 |
134 |
$17K |
| G0008 |
Administration of influenza virus vaccine |
676 |
676 |
$11K |
| 90674 |
|
331 |
331 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
138 |
137 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
65 |
65 |
$7K |
| 90661 |
|
116 |
116 |
$4K |
| 0012A |
|
57 |
57 |
$2K |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
1,315 |
1,237 |
$1K |
| 0011A |
|
29 |
28 |
$1K |
| 0064A |
|
24 |
24 |
$954.31 |
| 90688 |
|
14 |
14 |
$259.06 |
| 90658 |
|
17 |
17 |
$257.51 |
| G8418 |
Bmi is documented below normal parameters and a follow-up plan is documented |
372 |
353 |
$248.00 |
| 3074F |
|
31 |
30 |
$52.50 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
14 |
14 |
$36.00 |
| 3078F |
|
43 |
38 |
$30.00 |
| 91301 |
|
105 |
104 |
$0.04 |
| 1159F |
|
51 |
45 |
$0.00 |
| 1160F |
|
51 |
45 |
$0.00 |