| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
11,133 |
10,073 |
$1.19M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,993 |
3,716 |
$300K |
| 90837 |
Psychotherapy, 53 minutes with patient |
1,737 |
916 |
$198K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
140 |
121 |
$19K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
160 |
133 |
$11K |
| 86703 |
|
301 |
266 |
$8K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
295 |
257 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
280 |
226 |
$3K |
| 0012A |
|
82 |
46 |
$1K |
| 0011A |
|
47 |
44 |
$1K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
16 |
15 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17 |
16 |
$796.45 |
| 0002A |
|
49 |
29 |
$736.00 |
| 0004A |
|
47 |
31 |
$662.40 |
| 0071A |
|
26 |
16 |
$588.80 |
| D1206 |
Topical application of fluoride varnish |
16 |
15 |
$540.96 |
| 0072A |
|
23 |
13 |
$478.40 |
| 0001A |
|
16 |
14 |
$404.80 |
| 90480 |
|
15 |
12 |
$365.20 |
| 0013A |
|
26 |
18 |
$331.20 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
18 |
16 |
$329.12 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
15 |
13 |
$319.92 |
| 99406 |
|
14 |
13 |
$77.04 |
| 36415 |
Collection of venous blood by venipuncture |
73 |
68 |
$0.00 |
| 99450 |
|
27 |
24 |
$0.00 |