| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,323 |
5,977 |
$240K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,130 |
3,859 |
$223K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
66 |
66 |
$5K |
| Q3014 |
Telehealth originating site facility fee |
213 |
207 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
232 |
226 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
59 |
57 |
$2K |
| 96158 |
|
22 |
12 |
$1K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
24 |
24 |
$1K |
| 96127 |
|
189 |
175 |
$1K |
| 0011A |
|
24 |
24 |
$960.00 |
| 0012A |
|
20 |
20 |
$800.00 |
| 90686 |
|
68 |
67 |
$623.60 |
| 0002A |
|
12 |
12 |
$480.00 |
| 71046 |
Radiologic examination, chest; 2 views |
73 |
67 |
$473.22 |
| 71045 |
Radiologic examination, chest; single view |
14 |
13 |
$56.90 |
| 91301 |
|
75 |
75 |
$0.00 |
| 91300 |
|
26 |
26 |
$0.00 |