| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87428 |
|
332 |
274 |
$24K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
796 |
608 |
$23K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
175 |
153 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
232 |
194 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
35 |
32 |
$594.41 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
17 |
16 |
$267.00 |
| 90686 |
|
12 |
12 |
$213.51 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$150.34 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
20 |
17 |
$16.72 |
| 81003 |
|
17 |
16 |
$0.00 |