| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
32 |
28 |
$283.35 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
25 |
23 |
$199.65 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
38 |
17 |
$111.20 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
20 |
18 |
$57.05 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
26 |
24 |
$39.88 |
| 99000 |
|
16 |
14 |
$32.40 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
25 |
20 |
$10.00 |
| A4245 |
Alcohol wipes, per box |
16 |
15 |
$3.76 |
| 99050 |
|
15 |
13 |
$0.00 |
| 36416 |
|
14 |
14 |
$0.00 |
| 99401 |
|
14 |
13 |
$0.00 |