| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,115 |
3,559 |
$226K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,645 |
1,456 |
$79K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
288 |
273 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
15 |
$944.65 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$793.37 |
| 3074F |
|
1,920 |
1,708 |
$790.87 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$744.59 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$557.41 |
| 0012A |
|
104 |
90 |
$374.86 |
| 90686 |
|
75 |
70 |
$371.16 |
| 20610 |
|
39 |
29 |
$143.44 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
13 |
$129.60 |
| 0002A |
|
35 |
29 |
$31.23 |
| 36415 |
Collection of venous blood by venipuncture |
469 |
401 |
$30.60 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
53 |
41 |
$5.05 |
| 1126F |
|
429 |
381 |
$0.00 |
| 1101F |
|
160 |
134 |
$0.00 |
| 1220F |
|
758 |
680 |
$0.00 |
| 3079F |
|
183 |
164 |
$0.00 |
| 1125F |
|
219 |
172 |
$0.00 |
| 0011A |
|
15 |
13 |
$0.00 |
| 1159F |
|
640 |
562 |
$0.00 |
| 3078F |
|
1,539 |
1,382 |
$0.00 |
| 1160F |
|
611 |
539 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
39 |
38 |
$0.00 |
| 3288F |
|
85 |
78 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
45 |
25 |
$0.00 |