| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,189 |
4,032 |
$159K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,461 |
1,985 |
$105K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
881 |
685 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
75 |
65 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
29 |
29 |
$2K |
| 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 |
1,287 |
957 |
$2K |
| 81003 |
|
1,146 |
905 |
$833.26 |
| 0012A |
|
12 |
12 |
$375.51 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
72 |
72 |
$278.86 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
14 |
$99.20 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
67 |
43 |
$68.23 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
13 |
12 |
$41.76 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$32.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
13 |
13 |
$24.76 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
37 |
36 |
$15.60 |
| 3075F |
|
314 |
232 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
172 |
131 |
$0.00 |
| 91301 |
|
16 |
15 |
$0.00 |
| 1036F |
|
460 |
333 |
$0.00 |
| 3074F |
|
1,472 |
1,151 |
$0.00 |
| 3008F |
|
1,289 |
940 |
$0.00 |
| 1000F |
|
32 |
27 |
$0.00 |
| 3080F |
|
242 |
161 |
$0.00 |
| 3079F |
|
816 |
585 |
$0.00 |
| 1034F |
|
35 |
29 |
$0.00 |
| 1111F |
|
18 |
13 |
$0.00 |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
54 |
49 |
$0.00 |
| 3078F |
|
1,307 |
926 |
$0.00 |
| 3725F |
|
2,728 |
1,897 |
$0.00 |
| 3077F |
|
360 |
236 |
$0.00 |
| 99173 |
|
204 |
155 |
$0.00 |
| 1159F |
|
191 |
154 |
$0.00 |