| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,225 |
2,752 |
$101K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
961 |
749 |
$35K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
487 |
392 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
351 |
154 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
237 |
212 |
$2K |
| 90756 |
|
61 |
50 |
$1K |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
14 |
13 |
$899.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$625.87 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
46 |
37 |
$413.82 |
| 96160 |
|
13 |
13 |
$235.22 |
| 96127 |
|
35 |
33 |
$202.66 |
| 3079F |
|
267 |
233 |
$90.60 |
| 3078F |
|
284 |
256 |
$70.00 |
| 3074F |
|
348 |
313 |
$70.00 |
| 99173 |
|
16 |
16 |
$63.54 |
| 3075F |
|
75 |
64 |
$50.60 |
| 3077F |
|
230 |
203 |
$40.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
17 |
12 |
$30.68 |
| J1200 |
Injection, diphenhydramine hcl, up to 50 mg |
16 |
12 |
$9.88 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
19 |
14 |
$8.08 |
| 1159F |
|
389 |
332 |
$0.00 |
| 1160F |
|
387 |
330 |
$0.00 |
| 3080F |
|
93 |
82 |
$0.00 |