| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,088 |
1,637 |
$33K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
158 |
105 |
$616.81 |
| 90688 |
|
86 |
86 |
$192.30 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
159 |
106 |
$55.99 |
| J3411 |
Injection, thiamine hcl, 100 mg |
157 |
105 |
$27.28 |
| J3415 |
Injection, pyridoxine hcl, 100 mg |
157 |
105 |
$24.23 |
| J7050 |
Infusion, normal saline solution, 250 cc |
158 |
105 |
$23.94 |
| 36415 |
Collection of venous blood by venipuncture |
466 |
464 |
$2.40 |
| G0008 |
Administration of influenza virus vaccine |
15 |
15 |
$0.00 |