| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
176 |
157 |
$18K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
162 |
161 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
148 |
139 |
$10K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
72 |
69 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
41 |
41 |
$5K |
| 90716 |
|
51 |
48 |
$4K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
58 |
56 |
$2K |
| 90461 |
|
60 |
59 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
256 |
238 |
$2K |
| 99385 |
|
14 |
14 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
95 |
89 |
$2K |
| 90707 |
|
22 |
21 |
$2K |
| 90715 |
|
40 |
39 |
$1K |
| 90746 |
|
21 |
20 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
13 |
$1K |
| 90674 |
|
51 |
51 |
$950.00 |
| 90686 |
|
33 |
33 |
$639.21 |
| 86803 |
|
35 |
35 |
$449.40 |
| 90744 |
|
15 |
15 |
$403.65 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
80 |
73 |
$300.96 |
| 81003 |
|
131 |
130 |
$262.40 |
| 86703 |
|
21 |
21 |
$259.14 |
| G0433 |
Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening |
15 |
14 |
$246.90 |
| 99000 |
|
42 |
42 |
$0.00 |