| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 1125F |
|
781 |
749 |
$10K |
| 1159F |
|
1,463 |
1,331 |
$6K |
| 1126F |
|
316 |
297 |
$2K |
| 3008F |
|
2,010 |
1,866 |
$2K |
| 1160F |
|
1,458 |
1,326 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,845 |
1,787 |
$1K |
| 3078F |
|
1,942 |
1,857 |
$879.81 |
| 3074F |
|
2,096 |
2,007 |
$804.95 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
72 |
72 |
$186.28 |
| 1000F |
|
32 |
32 |
$183.42 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
307 |
295 |
$109.62 |
| 3077F |
|
28 |
25 |
$73.79 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
137 |
134 |
$0.00 |
| 80053 |
Comprehensive metabolic panel |
13 |
13 |
$0.00 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
15 |
15 |
$0.00 |
| 3079F |
|
155 |
147 |
$0.00 |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
38 |
25 |
$0.00 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
12 |
12 |
$0.00 |
| 81003 |
|
159 |
156 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
20 |
12 |
$0.00 |