| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,975 |
2,770 |
$226K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,149 |
1,961 |
$107K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
859 |
780 |
$100K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,163 |
1,077 |
$86K |
| 95165 |
Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy, multiple dose vials |
359 |
331 |
$49K |
| 95117 |
|
4,395 |
2,325 |
$47K |
| 92557 |
|
1,444 |
1,302 |
$30K |
| 92567 |
|
2,867 |
2,618 |
$27K |
| 95115 |
|
1,095 |
546 |
$9K |
| 42820 |
Tonsillectomy and adenoidectomy; younger than age 12 |
31 |
28 |
$6K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
22 |
21 |
$3K |
| 95024 |
|
17 |
17 |
$2K |
| 31575 |
|
47 |
46 |
$1K |
| 92504 |
|
58 |
52 |
$882.38 |
| 31231 |
|
26 |
25 |
$834.19 |
| 92556 |
|
13 |
13 |
$397.08 |
| 69210 |
|
54 |
41 |
$392.66 |
| 92550 |
|
28 |
24 |
$236.93 |
| 92552 |
|
13 |
13 |
$133.56 |
| G8482 |
Influenza immunization administered or previously received |
14 |
14 |
$0.00 |
| 4040F |
|
15 |
15 |
$0.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
15 |
14 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
175 |
165 |
$0.00 |