| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,923 |
4,374 |
$362K |
| S5102 |
Day care services, adult; per diem |
483 |
85 |
$80K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
386 |
359 |
$24K |
| 99443 |
|
546 |
517 |
$18K |
| 36415 |
Collection of venous blood by venipuncture |
554 |
407 |
$8K |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
354 |
137 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
83 |
62 |
$7K |
| 99442 |
|
154 |
138 |
$5K |
| 97110 |
Therapeutic procedure, each 15 minutes; therapeutic exercises to develop strength and endurance, flexibility and range of motion |
165 |
69 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
46 |
41 |
$3K |
| 90688 |
|
176 |
144 |
$2K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
114 |
74 |
$2K |
| 97161 |
|
20 |
12 |
$1K |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
27 |
24 |
$968.29 |
| 92015 |
Determination of refractive state |
476 |
455 |
$935.35 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
68 |
68 |
$815.98 |
| V2020 |
Frames, purchases |
24 |
24 |
$802.52 |
| 92250 |
|
28 |
28 |
$788.60 |
| 0012A |
|
16 |
16 |
$499.89 |
| 0011A |
|
24 |
24 |
$292.20 |
| 90686 |
|
16 |
13 |
$159.40 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
12 |
$136.72 |