| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,653 |
4,358 |
$414K |
| 99215 |
Prolong outpt/office vis |
3,898 |
2,662 |
$375K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,916 |
1,547 |
$90K |
| 99374 |
|
34 |
29 |
$48K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
151 |
134 |
$17K |
| 99354 |
|
252 |
139 |
$14K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
879 |
775 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
293 |
260 |
$4K |
| 82947 |
|
880 |
710 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
26 |
24 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
12 |
$1K |
| 90686 |
|
33 |
33 |
$653.07 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
362 |
340 |
$626.07 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
38 |
38 |
$572.00 |
| 90661 |
|
27 |
27 |
$557.25 |
| 90688 |
|
23 |
23 |
$455.17 |
| 90620 |
|
14 |
14 |
$277.06 |
| 80305 |
|
92 |
66 |
$261.75 |
| 81002 |
|
45 |
37 |
$84.00 |
| 84703 |
|
18 |
12 |
$72.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
179 |
168 |
$27.58 |
| G0008 |
Administration of influenza virus vaccine |
18 |
18 |
$0.00 |
| 90756 |
|
21 |
21 |
$0.00 |
| G0434 |
Drug screen, other than chromatographic; any number of drug classes, by clia waived test or moderate complexity test, per patient encounter |
138 |
108 |
$0.00 |