| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,555 |
5,215 |
$36K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,829 |
10,227 |
$33K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
805 |
798 |
$9K |
| 90686 |
|
553 |
546 |
$8K |
| 92552 |
|
367 |
365 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
60 |
56 |
$3K |
| 90707 |
|
36 |
35 |
$2K |
| 99441 |
|
675 |
603 |
$2K |
| 90715 |
|
42 |
41 |
$1K |
| 99385 |
|
13 |
13 |
$411.72 |
| 90651 |
|
12 |
12 |
$399.20 |
| 81000 |
|
222 |
221 |
$392.73 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
300 |
292 |
$297.98 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
515 |
507 |
$291.13 |
| 94060 |
|
40 |
40 |
$268.35 |
| 85018 |
|
106 |
106 |
$222.72 |
| 82948 |
|
593 |
543 |
$117.42 |
| 81002 |
|
159 |
158 |
$73.67 |
| 93000 |
|
25 |
25 |
$13.02 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
121 |
114 |
$12.03 |
| 82962 |
|
115 |
110 |
$9.55 |
| 86580 |
|
13 |
13 |
$7.40 |
| 3078F |
|
1,615 |
1,555 |
$0.00 |
| 3077F |
|
813 |
777 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
941 |
941 |
$0.00 |
| G8752 |
Most recent systolic blood pressure < 140 mmhg |
15 |
14 |
$0.00 |
| 3045F |
|
31 |
28 |
$0.00 |
| 3050F |
|
40 |
39 |
$0.00 |
| 3074F |
|
1,585 |
1,523 |
$0.00 |
| 3008F |
|
3,206 |
3,019 |
$0.00 |
| 3048F |
|
43 |
42 |
$0.00 |
| 3044F |
|
80 |
78 |
$0.00 |
| 3079F |
|
777 |
757 |
$0.00 |
| 3075F |
|
408 |
401 |
$0.00 |
| 3080F |
|
319 |
310 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
78 |
78 |
$0.00 |
| G8754 |
Most recent diastolic blood pressure < 90 mmhg |
16 |
15 |
$0.00 |
| 3049F |
|
42 |
42 |
$0.00 |