| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,938 |
2,474 |
$221K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
621 |
534 |
$42K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
442 |
375 |
$33K |
| 59426 |
|
62 |
25 |
$6K |
| 81000 |
|
322 |
255 |
$3K |
| 59425 |
|
18 |
12 |
$1K |
| 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 |
539 |
388 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
174 |
157 |
$949.57 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
30 |
27 |
$314.13 |
| 82948 |
|
16 |
14 |
$106.10 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
14 |
13 |
$104.71 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
43 |
37 |
$0.00 |
| 81002 |
|
57 |
39 |
$0.00 |
| 99173 |
|
47 |
41 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
14 |
13 |
$0.00 |
| A4208 |
Syringe with needle, sterile 3 cc, each |
31 |
24 |
$0.00 |
| 90686 |
|
74 |
65 |
$0.00 |
| 92551 |
|
46 |
38 |
$0.00 |
| 0011A |
|
19 |
13 |
$0.00 |