| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
693 |
582 |
$27K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
328 |
276 |
$4K |
| 71046 |
Radiologic examination, chest; 2 views |
36 |
33 |
$573.81 |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
55 |
12 |
$422.40 |
| 36415 |
Collection of venous blood by venipuncture |
151 |
130 |
$309.25 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
23 |
17 |
$214.95 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
21 |
15 |
$176.78 |