| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
2,288 |
605 |
$656K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
22,019 |
10,143 |
$620K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,198 |
7,759 |
$348K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
877 |
838 |
$339K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,212 |
841 |
$70K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,445 |
1,490 |
$68K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,785 |
926 |
$67K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,441 |
628 |
$42K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
891 |
498 |
$39K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,531 |
3,089 |
$28K |
| 99401 |
|
1,829 |
1,215 |
$25K |
| 97802 |
|
737 |
582 |
$21K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
165 |
141 |
$14K |
| 95018 |
|
877 |
838 |
$7K |
| 95076 |
|
862 |
823 |
$6K |
| 69210 |
|
332 |
232 |
$6K |
| 36415 |
Collection of venous blood by venipuncture |
1,701 |
1,077 |
$4K |
| 90651 |
|
398 |
204 |
$4K |
| 17110 |
|
65 |
28 |
$3K |
| 99188 |
|
789 |
244 |
$2K |
| 90461 |
|
2,675 |
1,232 |
$2K |
| 90716 |
|
305 |
201 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
14 |
14 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
285 |
101 |
$1K |
| 90707 |
|
294 |
196 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
444 |
304 |
$853.12 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$559.35 |
| 90715 |
|
36 |
24 |
$496.68 |
| 90700 |
|
259 |
183 |
$460.32 |
| 90656 |
|
107 |
107 |
$344.47 |
| 90633 |
|
390 |
229 |
$253.95 |
| 90697 |
|
192 |
128 |
$230.00 |
| 90713 |
|
14 |
14 |
$221.34 |
| 90688 |
|
381 |
257 |
$88.03 |
| 90648 |
|
82 |
49 |
$23.12 |
| 90680 |
|
150 |
116 |
$20.00 |
| 90686 |
|
334 |
292 |
$10.00 |
| 90619 |
|
226 |
126 |
$0.00 |
| 90620 |
|
252 |
157 |
$0.00 |
| 96127 |
|
108 |
87 |
$0.00 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
46 |
42 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
49 |
49 |
$0.00 |
| G8419 |
Bmi documented outside normal parameters, no follow-up plan documented, no reason given |
51 |
51 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
165 |
163 |
$0.00 |
| 99496 |
|
25 |
25 |
$0.00 |
| 90681 |
|
147 |
100 |
$0.00 |
| 90671 |
|
500 |
314 |
$0.00 |
| 90670 |
|
674 |
268 |
$0.00 |
| 99499 |
|
195 |
143 |
$0.00 |
| 90714 |
|
25 |
25 |
$0.00 |