| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,459 |
5,512 |
$405K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,573 |
4,647 |
$230K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
220 |
183 |
$16K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,725 |
1,721 |
$11K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,659 |
1,462 |
$10K |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
813 |
577 |
$9K |
| 90756 |
|
128 |
86 |
$604.58 |
| 82044 |
|
366 |
333 |
$522.00 |
| 99443 |
|
21 |
12 |
$235.15 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
187 |
139 |
$163.46 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
12 |
12 |
$88.00 |
| 99497 |
|
37 |
37 |
$66.09 |
| J2360 |
Injection, orphenadrine citrate, up to 60 mg |
14 |
12 |
$42.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
80 |
41 |
$35.00 |
| 81002 |
|
12 |
12 |
$21.00 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
62 |
36 |
$8.90 |
| 1126F |
|
371 |
352 |
$0.00 |
| 3080F |
|
18 |
17 |
$0.00 |
| 1170F |
|
838 |
774 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
76 |
75 |
$0.00 |
| 1125F |
|
59 |
55 |
$0.00 |
| 3074F |
|
136 |
129 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
28 |
25 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
12 |
12 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
14 |
12 |
$0.00 |
| 3044F |
|
12 |
12 |
$0.00 |
| 3079F |
|
51 |
49 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
860 |
785 |
$0.00 |
| 3077F |
|
52 |
46 |
$0.00 |
| 1159F |
|
29 |
26 |
$0.00 |
| 1160F |
|
29 |
26 |
$0.00 |
| 3078F |
|
109 |
101 |
$0.00 |