| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,883 |
3,651 |
$278K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,899 |
3,620 |
$208K |
| 99442 |
|
311 |
301 |
$22K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
22 |
12 |
$14K |
| 99215 |
Prolong outpt/office vis |
124 |
114 |
$13K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
261 |
234 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
133 |
127 |
$3K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
14 |
12 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
105 |
103 |
$2K |
| 90688 |
|
125 |
121 |
$2K |
| 99350 |
Prolong home eval add 15m |
14 |
14 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 90674 |
|
56 |
55 |
$1K |
| 90461 |
|
16 |
16 |
$663.18 |
| 99441 |
|
14 |
14 |
$346.35 |
| 81002 |
|
88 |
82 |
$228.49 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
13 |
$190.31 |
| 96127 |
|
30 |
30 |
$182.33 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
46 |
31 |
$67.72 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
46 |
31 |
$67.72 |
| 1159F |
|
2,046 |
1,904 |
$0.01 |
| 3074F |
|
4,156 |
3,905 |
$0.00 |
| 3075F |
|
495 |
485 |
$0.00 |
| 3079F |
|
1,312 |
1,249 |
$0.00 |
| 3080F |
|
299 |
282 |
$0.00 |
| 1125F |
|
2,771 |
2,541 |
$0.00 |
| 3008F |
|
5,392 |
5,015 |
$0.00 |
| 90686 |
|
83 |
77 |
$0.00 |
| 1126F |
|
2,847 |
2,705 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
191 |
174 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
1,136 |
1,047 |
$0.00 |
| 1160F |
|
2,240 |
2,070 |
$0.00 |
| 3078F |
|
3,425 |
3,229 |
$0.00 |
| 3077F |
|
741 |
681 |
$0.00 |
| 3288F |
|
16 |
14 |
$0.00 |