| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
8,514 |
4,509 |
$803K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,335 |
9,093 |
$625K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,383 |
1,163 |
$119K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,507 |
1,491 |
$71K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
281 |
279 |
$33K |
| 99205 |
Prolong outpt/office vis |
159 |
159 |
$26K |
| 90461 |
|
618 |
610 |
$25K |
| 90792 |
Psychiatric diagnostic evaluation with medical services |
95 |
95 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
66 |
66 |
$6K |
| 36415 |
Collection of venous blood by venipuncture |
868 |
837 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
86 |
84 |
$2K |
| 90686 |
|
340 |
336 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$871.92 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
46 |
44 |
$611.61 |
| 0012A |
|
15 |
15 |
$600.00 |
| 0011A |
|
14 |
14 |
$560.00 |
| 81003 |
|
87 |
85 |
$186.56 |
| 87807 |
|
12 |
12 |
$159.84 |
| 36416 |
|
16 |
14 |
$48.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
14 |
14 |
$9.90 |
| 90647 |
|
39 |
39 |
$0.00 |
| 90723 |
|
99 |
99 |
$0.00 |
| 90677 |
|
13 |
13 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |
| 91301 |
|
39 |
39 |
$0.00 |
| 90670 |
|
196 |
195 |
$0.00 |
| 90672 |
|
37 |
36 |
$0.00 |