| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,798 |
5,798 |
$181K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,156 |
3,642 |
$137K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
161 |
124 |
$8K |
| 80305 |
|
875 |
674 |
$4K |
| 99233 |
Prolong inpt eval add15 m |
32 |
13 |
$2K |
| 81002 |
|
518 |
456 |
$945.04 |
| 90674 |
|
98 |
70 |
$576.36 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
323 |
181 |
$558.44 |
| 99215 |
Prolong outpt/office vis |
97 |
86 |
$548.43 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
20 |
13 |
$308.22 |
| 90656 |
|
108 |
98 |
$296.55 |
| 90661 |
|
77 |
67 |
$184.25 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
23 |
12 |
$146.45 |
| 90686 |
|
199 |
115 |
$143.04 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
131 |
107 |
$128.31 |
| 86580 |
|
19 |
12 |
$84.27 |
| 90756 |
|
68 |
41 |
$67.92 |
| 90658 |
|
14 |
13 |
$12.73 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
98 |
50 |
$6.12 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
41 |
37 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
572 |
413 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
419 |
307 |
$0.00 |
| 1101F |
|
57 |
57 |
$0.00 |
| 1036F |
|
25 |
25 |
$0.00 |
| 1170F |
|
42 |
42 |
$0.00 |
| 3008F |
|
17 |
17 |
$0.00 |
| G8542 |
Functional outcome assessment using a standardized tool is documented; no functional deficiencies identified, care plan not required |
13 |
13 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
22 |
20 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
390 |
273 |
$0.00 |
| 1100F |
|
57 |
57 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
19 |
14 |
$0.00 |
| 3016F |
|
12 |
12 |
$0.00 |
| 1160F |
|
16 |
16 |
$0.00 |
| 1159F |
|
15 |
15 |
$0.00 |