| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
239 |
217 |
$21K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
168 |
168 |
$15K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
22 |
22 |
$196.22 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
43 |
43 |
$73.92 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
30 |
30 |
$33.97 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
15 |
13 |
$27.98 |
| 99000 |
|
34 |
34 |
$6.86 |
| 81002 |
|
39 |
39 |
$1.55 |
| 81025 |
|
12 |
12 |
$0.00 |