| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,091 |
6,449 |
$524K |
| 99215 |
Prolong outpt/office vis |
953 |
659 |
$64K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,580 |
1,236 |
$62K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
781 |
548 |
$5K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
68 |
54 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
36 |
29 |
$3K |
| Q3014 |
Telehealth originating site facility fee |
125 |
118 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
12 |
$869.58 |
| 93000 |
|
77 |
67 |
$840.77 |
| 90658 |
|
36 |
33 |
$313.20 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
13 |
$262.79 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
72 |
65 |
$260.00 |
| 90686 |
|
20 |
19 |
$254.54 |
| 99490 |
Ccm add 20min |
18 |
12 |
$40.01 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
58 |
52 |
$35.64 |
| 81002 |
|
14 |
12 |
$33.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
45 |
27 |
$17.51 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
117 |
103 |
$10.72 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
17 |
12 |
$0.00 |
| 99442 |
|
35 |
27 |
$0.00 |
| 3044F |
|
40 |
31 |
$0.00 |
| 3074F |
|
59 |
46 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
64 |
55 |
$0.00 |