| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,581 |
1,714 |
$86K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
636 |
407 |
$14K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
267 |
136 |
$2K |
| 90686 |
|
139 |
93 |
$782.42 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
113 |
84 |
$587.52 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
56 |
23 |
$438.56 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
49 |
38 |
$365.54 |
| 36415 |
Collection of venous blood by venipuncture |
299 |
183 |
$286.56 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
58 |
33 |
$256.73 |
| 81002 |
|
200 |
124 |
$164.61 |
| 4037F |
|
13 |
12 |
$0.00 |
| 1126F |
|
25 |
24 |
$0.00 |
| 1125F |
|
46 |
41 |
$0.00 |
| 3079F |
|
42 |
37 |
$0.00 |
| 1036F |
|
57 |
54 |
$0.00 |
| 3074F |
|
78 |
71 |
$0.00 |
| 3075F |
|
14 |
14 |
$0.00 |
| 1170F |
|
118 |
99 |
$0.00 |
| 3078F |
|
51 |
47 |
$0.00 |
| 1159F |
|
125 |
114 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
17 |
15 |
$0.00 |
| 1160F |
|
125 |
114 |
$0.00 |
| 4274F |
|
13 |
12 |
$0.00 |