| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,709 |
1,667 |
$123K |
| S9088 |
Services provided in an urgent care center (list in addition to code for service) |
2,341 |
2,276 |
$63K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
435 |
435 |
$53K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
618 |
608 |
$27K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
256 |
254 |
$21K |
| 99215 |
Prolong outpt/office vis |
116 |
114 |
$12K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
354 |
350 |
$7K |
| 99051 |
|
171 |
166 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
272 |
272 |
$3K |
| 81025 |
|
297 |
295 |
$2K |
| 90682 |
|
21 |
21 |
$683.74 |
| 81003 |
|
268 |
266 |
$654.14 |
| G0008 |
Administration of influenza virus vaccine |
19 |
19 |
$317.11 |
| 73630 |
|
14 |
13 |
$240.77 |
| A6449 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
15 |
15 |
$21.25 |
| 4010F |
|
14 |
14 |
$0.00 |
| 3080F |
|
12 |
12 |
$0.00 |
| 3074F |
|
14 |
14 |
$0.00 |
| 3079F |
|
28 |
27 |
$0.00 |
| 3078F |
|
16 |
15 |
$0.00 |
| 3077F |
|
26 |
26 |
$0.00 |