| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
977 |
831 |
$41K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
216 |
194 |
$11K |
| 99205 |
Prolong outpt/office vis |
45 |
39 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
398 |
356 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
19 |
15 |
$803.92 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
161 |
95 |
$659.44 |
| 86328 |
|
15 |
15 |
$513.52 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
16 |
16 |
$80.46 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
77 |
54 |
$11.07 |