| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
13,979 |
11,163 |
$978K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
21,150 |
12,447 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,133 |
4,235 |
$919.33 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
166 |
166 |
$288.95 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
26 |
16 |
$98.91 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
419 |
353 |
$68.21 |
| 90688 |
|
165 |
119 |
$20.07 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
2,679 |
1,614 |
$8.60 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
214 |
191 |
$8.02 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
334 |
150 |
$5.77 |
| 83655 |
|
678 |
391 |
$5.00 |
| 85018 |
|
763 |
444 |
$2.07 |
| 82962 |
|
879 |
470 |
$1.80 |
| 81025 |
|
164 |
95 |
$0.00 |
| 3078F |
|
516 |
322 |
$0.00 |
| 3077F |
|
492 |
299 |
$0.00 |
| 92552 |
|
630 |
369 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
52 |
27 |
$0.00 |
| 81002 |
|
465 |
313 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
17 |
13 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
111 |
62 |
$0.00 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
62 |
43 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
23 |
13 |
$0.00 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
31 |
21 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,741 |
1,070 |
$0.00 |
| 3074F |
|
409 |
258 |
$0.00 |
| 3079F |
|
329 |
198 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
44 |
38 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
61 |
43 |
$0.00 |
| 3075F |
|
83 |
50 |
$0.00 |
| 3080F |
|
79 |
54 |
$0.00 |
| 90674 |
|
46 |
44 |
$0.00 |
| 86580 |
|
18 |
12 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
40 |
15 |
$0.00 |