| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,972 |
6,093 |
$444K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,728 |
4,837 |
$259K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
241 |
232 |
$22K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
660 |
531 |
$17K |
| 95943 |
|
217 |
169 |
$11K |
| 95923 |
|
171 |
149 |
$11K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
711 |
643 |
$7K |
| 90688 |
|
385 |
359 |
$4K |
| 99497 |
|
197 |
170 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
308 |
284 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
16 |
16 |
$1K |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
16 |
14 |
$815.27 |
| 90656 |
|
43 |
43 |
$669.19 |
| 86580 |
|
26 |
25 |
$220.50 |
| 99397 |
|
19 |
18 |
$101.94 |
| 36416 |
|
109 |
101 |
$99.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
31 |
28 |
$88.33 |
| S9999 |
Sales tax |
533 |
408 |
$51.79 |
| A4456 |
Adhesive remover, wipes, any type, each |
256 |
226 |
$33.06 |
| G0008 |
Administration of influenza virus vaccine |
92 |
71 |
$19.00 |
| 3074F |
|
1,079 |
986 |
$1.08 |
| 3078F |
|
844 |
769 |
$0.88 |
| 3079F |
|
359 |
332 |
$0.30 |
| 1170F |
|
143 |
116 |
$0.14 |
| 3075F |
|
59 |
56 |
$0.09 |
| 1124F |
|
135 |
104 |
$0.02 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
61 |
50 |
$0.00 |