| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,861 |
2,527 |
$173K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,071 |
1,057 |
$96K |
| 99442 |
|
1,828 |
1,660 |
$92K |
| 94010 |
|
902 |
897 |
$19K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
167 |
160 |
$17K |
| 93000 |
|
1,148 |
1,138 |
$14K |
| 90756 |
|
291 |
291 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
667 |
654 |
$6K |
| 90674 |
|
216 |
209 |
$5K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
74 |
25 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
26 |
26 |
$2K |
| 81002 |
|
1,575 |
1,541 |
$2K |
| 90685 |
|
71 |
71 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
30 |
12 |
$1K |
| 99401 |
|
30 |
30 |
$916.50 |
| 36415 |
Collection of venous blood by venipuncture |
1,721 |
1,666 |
$809.26 |
| 96366 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; each additional hour |
35 |
13 |
$631.76 |
| 90656 |
|
15 |
15 |
$334.07 |
| J3415 |
Injection, pyridoxine hcl, 100 mg |
35 |
13 |
$161.00 |
| 82947 |
|
32 |
28 |
$120.37 |
| J3430 |
Injection, phytonadione (vitamin k), per 1 mg |
35 |
13 |
$78.56 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
74 |
25 |
$58.40 |
| J3411 |
Injection, thiamine hcl, 100 mg |
35 |
13 |
$52.08 |
| G0008 |
Administration of influenza virus vaccine |
13 |
13 |
$32.99 |
| 99072 |
|
67 |
64 |
$20.00 |
| J3475 |
Injection, magnesium sulfate, per 500 mg |
35 |
13 |
$8.56 |