| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
860 |
689 |
$40K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
149 |
134 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
208 |
90 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
210 |
113 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
70 |
59 |
$644.87 |
| 36415 |
Collection of venous blood by venipuncture |
225 |
193 |
$201.69 |
| 90686 |
|
13 |
13 |
$65.49 |
| 81003 |
|
50 |
41 |
$40.03 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
16 |
13 |
$14.83 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
29 |
25 |
$4.64 |
| G0008 |
Administration of influenza virus vaccine |
14 |
14 |
$0.00 |
| 1036F |
|
17 |
13 |
$0.00 |