| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,511 |
1,324 |
$86K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
172 |
159 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
189 |
155 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
41 |
36 |
$817.64 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
192 |
150 |
$476.63 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$176.40 |
| 92551 |
|
17 |
17 |
$138.91 |
| 81003 |
|
53 |
48 |
$94.08 |
| 99173 |
|
18 |
18 |
$31.59 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
62 |
56 |
$10.88 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
29 |
26 |
$0.68 |
| 3008F |
|
54 |
30 |
$0.00 |
| 1159F |
|
22 |
12 |
$0.00 |
| 1160F |
|
24 |
13 |
$0.00 |