| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,269 |
2,408 |
$65K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,089 |
855 |
$40K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,392 |
1,023 |
$22K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
577 |
457 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
40 |
38 |
$698.64 |
| 92567 |
|
37 |
25 |
$386.62 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
18 |
18 |
$176.54 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
901 |
702 |
$62.33 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
18 |
12 |
$28.18 |
| 1160F |
|
28 |
26 |
$0.00 |
| 1159F |
|
28 |
26 |
$0.00 |