| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,032 |
927 |
$42K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
122 |
111 |
$7K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
254 |
217 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
36 |
35 |
$2K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
38 |
38 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
174 |
84 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
24 |
19 |
$2K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
89 |
78 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
18 |
14 |
$897.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
52 |
40 |
$673.78 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
30 |
27 |
$317.26 |
| 81003 |
|
226 |
210 |
$312.94 |
| 81025 |
|
30 |
26 |
$129.35 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
34 |
33 |
$122.79 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
106 |
89 |
$94.99 |
| 90658 |
|
18 |
15 |
$41.22 |
| 3078F |
|
172 |
160 |
$0.00 |
| 3074F |
|
215 |
205 |
$0.00 |
| 3079F |
|
75 |
73 |
$0.00 |