| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
206 |
177 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
45 |
45 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
130 |
59 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
14 |
$983.36 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
47 |
40 |
$668.84 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
29 |
23 |
$539.26 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
51 |
44 |
$512.78 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
16 |
12 |
$223.26 |
| 81025 |
|
19 |
17 |
$82.59 |
| 81003 |
|
35 |
33 |
$66.05 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
29 |
24 |
$30.52 |