| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
414 |
249 |
$11K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
106 |
57 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
102 |
57 |
$283.14 |
| 87400 |
|
106 |
57 |
$147.63 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
15 |
14 |
$120.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
17 |
16 |
$45.00 |
| 36415 |
Collection of venous blood by venipuncture |
36 |
28 |
$30.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
34 |
16 |
$0.00 |