| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,098 |
3,236 |
$165K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,554 |
3,559 |
$140K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
224 |
157 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
39 |
24 |
$2K |
| 99442 |
|
90 |
75 |
$2K |
| 90656 |
|
124 |
86 |
$2K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
29 |
25 |
$2K |
| 1159F |
|
752 |
499 |
$2K |
| 3008F |
|
1,054 |
723 |
$1K |
| 1160F |
|
485 |
303 |
$1K |
| 3074F |
|
599 |
379 |
$1K |
| 90686 |
|
103 |
90 |
$1K |
| 3078F |
|
497 |
322 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
962 |
862 |
$1K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
945 |
660 |
$1K |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
742 |
514 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
12 |
$868.31 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
118 |
86 |
$590.01 |
| 99422 |
|
44 |
37 |
$517.68 |
| 3044F |
|
395 |
272 |
$450.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
86 |
63 |
$422.51 |
| 1111F |
|
34 |
24 |
$120.00 |
| 81003 |
|
65 |
54 |
$89.10 |
| 93000 |
|
13 |
13 |
$83.54 |
| 1125F |
|
55 |
39 |
$70.00 |
| 90662 |
|
40 |
38 |
$64.64 |
| 1126F |
|
65 |
40 |
$60.00 |
| G0008 |
Administration of influenza virus vaccine |
152 |
133 |
$35.04 |
| 3079F |
|
18 |
15 |
$20.00 |
| 1003F |
|
754 |
503 |
$0.00 |
| 3288F |
|
175 |
110 |
$0.00 |
| 1090F |
|
299 |
201 |
$0.00 |
| 3048F |
|
128 |
85 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
41 |
34 |
$0.00 |
| 1101F |
|
225 |
147 |
$0.00 |