| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,696 |
2,272 |
$160K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,001 |
919 |
$112K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
941 |
763 |
$9K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
189 |
184 |
$8K |
| 90461 |
|
464 |
107 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
93 |
85 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
88 |
86 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
871 |
277 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
61 |
47 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
150 |
60 |
$610.00 |
| 90670 |
|
58 |
46 |
$360.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
72 |
33 |
$112.38 |
| 90723 |
|
22 |
13 |
$104.00 |
| 90680 |
|
21 |
12 |
$96.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
71 |
41 |
$42.24 |
| 3074F |
|
2,017 |
1,770 |
$0.00 |
| 94761 |
|
29 |
28 |
$0.00 |
| 3078F |
|
2,015 |
1,775 |
$0.00 |