| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
3,119 |
2,489 |
$107K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
2,230 |
1,920 |
$89K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,031 |
1,350 |
$85K |
| M0245 |
Intravenous infusion, bamlanivimab and etesevimab, includes infusion and post administration monitoring |
91 |
46 |
$36K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
835 |
441 |
$20K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
253 |
148 |
$19K |
| 0011A |
|
540 |
457 |
$12K |
| M0247 |
Intravenous infusion, sotrovimab, includes infusion and post administration monitoring |
32 |
21 |
$10K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
26 |
14 |
$10K |
| M0222 |
Intravenous injection, bebtelovimab, includes injection and post administration monitoring |
29 |
28 |
$10K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
209 |
203 |
$6K |
| 0012A |
|
178 |
162 |
$5K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
13 |
12 |
$667.03 |
| 91301 |
|
23 |
21 |
$0.13 |
| Q0247 |
Injection, sotrovimab, 500 mg |
27 |
15 |
$0.05 |
| 99072 |
|
42 |
21 |
$0.00 |