| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 65778 |
|
769 |
766 |
$971K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
3,851 |
3,825 |
$520K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
4,598 |
4,533 |
$416K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
4,856 |
4,747 |
$376K |
| 92083 |
|
4,972 |
4,955 |
$281K |
| 92133 |
|
6,353 |
6,323 |
$195K |
| 92250 |
|
4,804 |
4,764 |
$170K |
| 92020 |
|
6,828 |
6,544 |
$167K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,654 |
1,635 |
$79K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
1,097 |
1,096 |
$76K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
1,087 |
1,083 |
$71K |
| 92136 |
|
3,139 |
1,614 |
$69K |
| 95024 |
|
160 |
139 |
$66K |
| 68761 |
|
551 |
290 |
$64K |
| 95923 |
|
308 |
308 |
$32K |
| 76513 |
|
211 |
135 |
$23K |
| 93922 |
|
316 |
316 |
$22K |
| 95921 |
|
308 |
308 |
$21K |
| 76514 |
|
3,278 |
2,185 |
$20K |
| 92225 |
|
442 |
307 |
$16K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
109 |
66 |
$15K |
| 92134 |
|
321 |
321 |
$13K |
| 92286 |
|
302 |
301 |
$10K |
| 80305 |
|
1,734 |
1,727 |
$10K |
| 92275 |
|
59 |
59 |
$8K |
| 95930 |
|
59 |
59 |
$4K |
| 92226 |
|
65 |
63 |
$3K |
| 92285 |
|
84 |
80 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
1,863 |
1,857 |
$2K |
| 99403 |
|
34 |
34 |
$924.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$684.15 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
123 |
119 |
$578.68 |
| 92202 |
|
53 |
53 |
$558.97 |
| 86580 |
|
53 |
53 |
$412.68 |
| 92201 |
|
15 |
15 |
$253.83 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$152.98 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
18 |
18 |
$80.00 |