| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16,540 |
13,546 |
$778K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,055 |
6,117 |
$437K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,267 |
559 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
108 |
95 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
131 |
121 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
97 |
92 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
71 |
69 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
835 |
527 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
43 |
41 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
244 |
208 |
$3K |
| 99215 |
Prolong outpt/office vis |
26 |
12 |
$2K |
| 90688 |
|
18 |
17 |
$153.36 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
149 |
133 |
$95.51 |
| 81000 |
|
13 |
12 |
$44.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
32 |
26 |
$40.76 |
| 36415 |
Collection of venous blood by venipuncture |
12 |
12 |
$8.00 |
| 3078F |
|
20 |
15 |
$0.00 |
| 97802 |
|
431 |
376 |
$0.00 |
| 1125F |
|
17 |
17 |
$0.00 |
| 3074F |
|
40 |
34 |
$0.00 |
| 3008F |
|
256 |
222 |
$0.00 |
| 3079F |
|
15 |
14 |
$0.00 |
| 1126F |
|
16 |
16 |
$0.00 |