| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,971 |
2,713 |
$111K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,018 |
1,001 |
$70K |
| 11102 |
|
1,015 |
940 |
$48K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
488 |
463 |
$31K |
| 96922 |
|
84 |
24 |
$11K |
| 17110 |
|
110 |
98 |
$7K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
62 |
62 |
$6K |
| 96920 |
|
45 |
12 |
$2K |
| 11103 |
|
64 |
57 |
$2K |
| J7308 |
Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg) |
20 |
15 |
$951.85 |
| 17000 |
|
65 |
56 |
$458.60 |
| 17003 |
|
21 |
19 |
$146.12 |