| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,971 |
3,635 |
$31K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
67 |
66 |
$2K |
| 90688 |
|
261 |
261 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
121 |
117 |
$885.13 |
| Q2035 |
Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (afluria) |
71 |
71 |
$478.70 |
| 90686 |
|
38 |
37 |
$248.22 |
| G0008 |
Administration of influenza virus vaccine |
107 |
107 |
$226.48 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
331 |
326 |
$140.00 |
| 90694 |
|
15 |
14 |
$75.81 |
| 3008F |
|
639 |
629 |
$30.30 |
| 4040F |
|
13 |
13 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
14 |
14 |
$0.00 |
| 3725F |
|
40 |
40 |
$0.00 |
| 1160F |
|
12 |
12 |
$0.00 |
| 99397 |
|
25 |
25 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
16 |
16 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
119 |
115 |
$0.00 |
| 1101F |
|
16 |
16 |
$0.00 |
| 1170F |
|
12 |
12 |
$0.00 |
| 1036F |
|
15 |
15 |
$0.00 |