| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
840 |
764 |
$88K |
| 95199 |
|
3,016 |
1,054 |
$85K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
641 |
611 |
$39K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
334 |
334 |
$31K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,482 |
830 |
$28K |
| 95144 |
|
2,465 |
831 |
$18K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,109 |
1,015 |
$17K |
| 99243 |
|
211 |
207 |
$4K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
77 |
77 |
$3K |
| 99460 |
|
33 |
32 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
86 |
86 |
$2K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
28 |
28 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
61 |
60 |
$959.92 |
| 95117 |
|
331 |
131 |
$888.63 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
44 |
44 |
$822.65 |
| 90670 |
|
27 |
27 |
$721.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
82 |
82 |
$701.12 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
48 |
40 |
$589.54 |
| 92552 |
|
193 |
193 |
$581.24 |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
44 |
44 |
$452.02 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
29 |
29 |
$378.08 |
| 86580 |
|
233 |
233 |
$277.97 |
| 90648 |
|
25 |
25 |
$234.35 |
| 85018 |
|
152 |
152 |
$153.86 |
| 90658 |
|
14 |
14 |
$88.35 |
| 83655 |
|
13 |
13 |
$60.38 |
| 81002 |
|
63 |
63 |
$49.11 |
| 87081 |
|
100 |
98 |
$47.34 |
| 81000 |
|
54 |
53 |
$37.23 |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
507 |
190 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
160 |
160 |
$0.00 |
| 99173 |
|
47 |
47 |
$0.00 |
| 90461 |
|
38 |
38 |
$0.00 |