| Code | Description | Claims | Beneficiaries | Total Paid |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,495 |
3,953 |
$203K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,275 |
1,269 |
$84K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
338 |
335 |
$34K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
714 |
689 |
$30K |
| 71046 |
Radiologic examination, chest; 2 views |
798 |
543 |
$9K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
185 |
185 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
622 |
612 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
327 |
217 |
$4K |
| 81025 |
|
467 |
448 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
150 |
149 |
$2K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
62 |
60 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
64 |
64 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
159 |
137 |
$1K |
| 86328 |
|
33 |
33 |
$1K |
| 74019 |
|
89 |
59 |
$1K |
| 81000 |
|
376 |
365 |
$828.47 |
| 81002 |
|
289 |
279 |
$566.90 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
170 |
93 |
$470.05 |
| ATP14 |
|
13 |
13 |
$108.01 |
| 80053 |
Comprehensive metabolic panel |
54 |
53 |
$89.38 |
| 80047 |
|
16 |
16 |
$30.56 |
| 80076 |
|
14 |
14 |
$11.61 |
| 36415 |
Collection of venous blood by venipuncture |
93 |
93 |
$8.44 |
| A6455 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard |
26 |
25 |
$0.00 |