| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,304 |
2,681 |
$651K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,606 |
1,985 |
$442K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
282 |
257 |
$47K |
| 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 |
458 |
350 |
$23K |
| 92250 |
|
256 |
239 |
$8K |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
12 |
12 |
$2K |
| 0071A |
|
35 |
34 |
$1K |
| 0002A |
|
65 |
59 |
$1K |
| 0072A |
|
21 |
21 |
$800.00 |
| 0064A |
|
46 |
45 |
$436.86 |
| 0001A |
|
14 |
14 |
$131.05 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
241 |
222 |
$83.36 |
| 99173 |
|
12 |
12 |
$2.52 |
| 91300 |
|
91 |
79 |
$0.03 |
| V2020 |
Frames, purchases |
67 |
63 |
$0.00 |
| 92015 |
Determination of refractive state |
198 |
186 |
$0.00 |
| 90658 |
|
40 |
40 |
$0.00 |
| 92552 |
|
12 |
12 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
33 |
30 |
$0.00 |
| 90656 |
|
17 |
16 |
$0.00 |
| V2756 |
Eye glass case |
67 |
63 |
$0.00 |
| 91301 |
|
64 |
62 |
$0.00 |
| 91307 |
|
52 |
52 |
$0.00 |