| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
383 |
344 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
254 |
209 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
113 |
88 |
$316.55 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
23 |
12 |
$243.52 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
70 |
57 |
$18.17 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
22 |
14 |
$3.40 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
15 |
15 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
29 |
29 |
$0.00 |