| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
127 |
100 |
$3K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
76 |
61 |
$281.13 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
33 |
28 |
$166.64 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
43 |
31 |
$138.39 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
13 |
$134.48 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
14 |
14 |
$39.20 |
| 3078F |
|
32 |
27 |
$0.00 |
| 1159F |
|
123 |
100 |
$0.00 |
| 1160F |
|
123 |
100 |
$0.00 |
| 3074F |
|
14 |
13 |
$0.00 |