| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15,598 |
11,872 |
$628K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,598 |
10,793 |
$496K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,121 |
1,789 |
$153K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
289 |
257 |
$16K |
| 0001A |
|
359 |
341 |
$10K |
| 0002A |
|
316 |
300 |
$10K |
| 99173 |
|
569 |
475 |
$7K |
| 0004A |
|
170 |
148 |
$5K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
942 |
859 |
$5K |
| 82962 |
|
2,854 |
2,223 |
$4K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
102 |
89 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
273 |
220 |
$3K |
| 90686 |
|
205 |
174 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
138 |
99 |
$3K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
35 |
33 |
$2K |
| 81025 |
|
274 |
210 |
$2K |
| 81002 |
|
798 |
659 |
$1K |
| 93000 |
|
113 |
87 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
476 |
372 |
$1K |
| 94010 |
|
36 |
32 |
$998.16 |
| 92552 |
|
113 |
77 |
$758.47 |
| 90688 |
|
18 |
18 |
$438.14 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
26 |
18 |
$265.06 |
| 90674 |
|
15 |
15 |
$252.23 |
| 86580 |
|
42 |
35 |
$183.90 |
| 99000 |
|
86 |
54 |
$152.88 |
| 90658 |
|
20 |
12 |
$143.48 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
179 |
148 |
$63.14 |
| 96127 |
|
16 |
12 |
$39.40 |
| 91300 |
|
904 |
761 |
$8.33 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
17 |
16 |
$7.14 |
| G0008 |
Administration of influenza virus vaccine |
27 |
25 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
96 |
84 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
59 |
33 |
$0.00 |
| 99406 |
|
25 |
21 |
$0.00 |