| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,215 |
1,104 |
$4K |
| 90658 |
|
531 |
531 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,792 |
3,728 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21,009 |
17,808 |
$2K |
| 93000 |
|
260 |
259 |
$945.00 |
| J0690 |
Injection, cefazolin sodium, 500 mg |
1,089 |
1,004 |
$825.00 |
| G0008 |
Administration of influenza virus vaccine |
495 |
495 |
$801.50 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
793 |
725 |
$729.64 |
| 88150 |
|
54 |
54 |
$405.00 |
| 92551 |
|
1,048 |
1,047 |
$361.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
15 |
15 |
$40.00 |
| 3008F |
|
3,232 |
3,209 |
$36.00 |
| 90655 |
|
139 |
139 |
$24.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,348 |
1,326 |
$17.08 |
| 92081 |
|
1,179 |
1,178 |
$15.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$15.00 |
| 36415 |
Collection of venous blood by venipuncture |
5,405 |
5,339 |
$13.50 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
1,203 |
1,038 |
$5.04 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
5,669 |
4,983 |
$4.57 |
| 81002 |
|
1,011 |
977 |
$2.15 |
| 85018 |
|
1,060 |
1,039 |
$2.05 |
| 0001A |
|
14 |
14 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 90649 |
|
67 |
67 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$0.00 |
| 91300 |
|
66 |
57 |
$0.00 |
| 3078F |
|
12 |
12 |
$0.00 |