| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,999 |
3,824 |
$107K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
211 |
200 |
$21K |
| 99397 |
|
25 |
25 |
$2K |
| 90658 |
|
44 |
42 |
$493.66 |
| 90688 |
|
26 |
26 |
$391.62 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
26 |
26 |
$255.78 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
41 |
41 |
$109.88 |
| 1003F |
|
26 |
26 |
$0.00 |
| 1159F |
|
87 |
86 |
$0.00 |
| 3078F |
|
13 |
13 |
$0.00 |
| 1160F |
|
12 |
12 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
13 |
13 |
$0.00 |
| 1158F |
|
13 |
13 |
$0.00 |
| 3061F |
|
12 |
12 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
106 |
104 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
67 |
67 |
$0.00 |
| 1170F |
|
25 |
25 |
$0.00 |
| 3074F |
|
12 |
12 |
$0.00 |