| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,077 |
4,856 |
$264K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,175 |
2,087 |
$84K |
| 90686 |
|
644 |
636 |
$7K |
| 90750 |
|
38 |
38 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
61 |
60 |
$5K |
| G0008 |
Administration of influenza virus vaccine |
476 |
467 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
73 |
71 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
30 |
29 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
75 |
74 |
$3K |
| 3074F |
|
473 |
462 |
$3K |
| 90715 |
|
90 |
90 |
$2K |
| 90732 |
|
35 |
35 |
$2K |
| 3079F |
|
288 |
283 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16 |
16 |
$1K |
| 3078F |
|
239 |
238 |
$1K |
| 99384 |
|
12 |
12 |
$1K |
| 3077F |
|
220 |
218 |
$1K |
| 3080F |
|
185 |
181 |
$870.00 |
| 99385 |
|
13 |
13 |
$586.35 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
54 |
54 |
$387.42 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
27 |
27 |
$302.73 |
| G0009 |
Administration of pneumococcal vaccine |
43 |
40 |
$302.50 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
15 |
13 |
$266.70 |
| 3075F |
|
42 |
42 |
$230.00 |
| 90734 |
|
15 |
15 |
$110.00 |
| 99173 |
|
61 |
56 |
$103.50 |
| 92551 |
|
20 |
18 |
$59.40 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
37 |
37 |
$16.02 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
12 |
12 |
$6.37 |
| 3008F |
|
2,472 |
2,164 |
$0.00 |
| 90677 |
|
13 |
13 |
$0.00 |