| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
531 |
451 |
$27K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
44 |
40 |
$3K |
| S9999 |
Sales tax |
413 |
291 |
$3K |
| 90461 |
|
96 |
43 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
60 |
59 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
61 |
60 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
44 |
44 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
32 |
31 |
$521.13 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
28 |
26 |
$439.70 |
| 99080 |
|
65 |
64 |
$320.00 |
| 87807 |
|
12 |
12 |
$184.13 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
13 |
13 |
$83.54 |
| 90658 |
|
46 |
45 |
$12.31 |
| 90700 |
|
13 |
12 |
$0.00 |
| 90647 |
|
13 |
12 |
$0.00 |
| 90732 |
|
13 |
12 |
$0.00 |