| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
490 |
465 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
116 |
97 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
15 |
14 |
$101.91 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
15 |
14 |
$6.75 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
12 |
12 |
$1.96 |
| 90688 |
|
30 |
30 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
29 |
29 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
17 |
15 |
$0.00 |