| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,079 |
1,604 |
$82K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,804 |
1,449 |
$45K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
29 |
29 |
$1K |
| 90688 |
|
44 |
41 |
$436.05 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
18 |
14 |
$248.35 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$60.00 |
| 1101F |
|
33 |
28 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
15 |
14 |
$0.00 |
| 3288F |
|
33 |
28 |
$0.00 |
| 90662 |
|
14 |
13 |
$0.00 |