| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,095 |
1,840 |
$158K |
| 99215 |
Prolong outpt/office vis |
1,206 |
1,071 |
$111K |
| 99199 |
Unlisted special service, procedure or report |
15,539 |
15,034 |
$56K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
277 |
258 |
$33K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
291 |
272 |
$15K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
413 |
344 |
$7K |
| 71046 |
Radiologic examination, chest; 2 views |
288 |
273 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
355 |
172 |
$4K |
| 81025 |
|
637 |
564 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
42 |
41 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
223 |
216 |
$3K |
| 81003 |
|
1,356 |
1,241 |
$3K |
| 99383 |
|
18 |
17 |
$2K |
| 93000 |
|
104 |
98 |
$1K |
| 99384 |
|
17 |
15 |
$1K |
| 80305 |
|
70 |
65 |
$636.11 |
| 72100 |
|
19 |
17 |
$456.83 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
19 |
17 |
$174.41 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
18 |
17 |
$163.41 |
| 82962 |
|
78 |
71 |
$130.10 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
28 |
26 |
$121.27 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
169 |
162 |
$86.57 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
13 |
12 |
$2.00 |
| 90674 |
|
34 |
33 |
$0.00 |