| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,239 |
3,266 |
$115K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
800 |
674 |
$30K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
358 |
320 |
$26K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
81 |
78 |
$20K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
247 |
228 |
$18K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,763 |
1,523 |
$16K |
| 90686 |
|
1,510 |
1,296 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
462 |
383 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
63 |
39 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
50 |
46 |
$344.08 |
| 96160 |
|
271 |
217 |
$308.30 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
52 |
49 |
$250.88 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
345 |
272 |
$100.51 |
| 3075F |
|
64 |
48 |
$0.00 |
| 90650 |
|
26 |
26 |
$0.00 |
| 1111F |
|
76 |
60 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
18 |
12 |
$0.00 |
| 4010F |
|
14 |
12 |
$0.00 |
| 99001 |
|
15 |
14 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |