| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,554 |
2,294 |
$154K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,198 |
1,096 |
$110K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
281 |
268 |
$25K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
301 |
280 |
$17K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
717 |
633 |
$14K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
64 |
54 |
$7K |
| 71046 |
Radiologic examination, chest; 2 views |
312 |
261 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
518 |
246 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
60 |
50 |
$5K |
| 93000 |
|
386 |
331 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
246 |
235 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
141 |
112 |
$2K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
100 |
95 |
$2K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
94 |
85 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
88 |
79 |
$2K |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
19 |
16 |
$2K |
| 81025 |
|
259 |
248 |
$1K |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
83 |
80 |
$1K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
95 |
86 |
$1K |
| 81003 |
|
673 |
633 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
107 |
90 |
$940.02 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
32 |
30 |
$934.08 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
13 |
13 |
$840.53 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
242 |
234 |
$293.30 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
64 |
58 |
$277.07 |
| 99406 |
|
22 |
15 |
$109.64 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
14 |
12 |
$59.07 |
| 36415 |
Collection of venous blood by venipuncture |
15 |
13 |
$48.40 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
15 |
14 |
$24.23 |
| 3078F |
|
492 |
458 |
$0.00 |
| 3077F |
|
94 |
92 |
$0.00 |
| 99401 |
|
17 |
14 |
$0.00 |
| 90461 |
|
67 |
49 |
$0.00 |
| 99173 |
|
20 |
18 |
$0.00 |
| 3074F |
|
668 |
616 |
$0.00 |
| 3080F |
|
100 |
97 |
$0.00 |
| 90651 |
|
15 |
13 |
$0.00 |
| 3075F |
|
99 |
94 |
$0.00 |
| 3079F |
|
273 |
261 |
$0.00 |