| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99215 |
Prolong outpt/office vis |
706 |
680 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,056 |
1,024 |
$1K |
| 90686 |
|
26 |
26 |
$300.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
80 |
79 |
$200.00 |
| 96156 |
|
181 |
181 |
$130.00 |
| 90756 |
|
19 |
19 |
$75.00 |
| S3005 |
Performance measurement, evaluation of patient self assessment, depression |
344 |
344 |
$39.00 |
| G8482 |
Influenza immunization administered or previously received |
111 |
111 |
$0.30 |
| 3008F |
|
25 |
25 |
$0.00 |
| 96151 |
|
13 |
13 |
$0.00 |
| 99484 |
|
15 |
14 |
$0.00 |
| 96127 |
|
12 |
12 |
$0.00 |
| 99417 |
Prolong home eval add 15m |
14 |
14 |
$0.00 |
| 96158 |
|
191 |
190 |
$0.00 |