| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,191 |
1,039 |
$82K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,620 |
1,406 |
$79K |
| S9088 |
Services provided in an urgent care center (list in addition to code for service) |
3,057 |
2,667 |
$42K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
219 |
194 |
$13K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
110 |
99 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
46 |
44 |
$4K |
| 17110 |
|
16 |
13 |
$902.21 |
| 87428 |
|
14 |
12 |
$632.52 |
| 11102 |
|
15 |
12 |
$492.62 |
| 17000 |
|
26 |
14 |
$375.91 |
| 99051 |
|
53 |
49 |
$0.00 |
| S9999 |
Sales tax |
80 |
67 |
$0.00 |