| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
11,387 |
10,706 |
$1.06M |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
7,105 |
7,101 |
$880K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
5,892 |
5,888 |
$527K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,382 |
7,865 |
$456K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
2,532 |
2,487 |
$98K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
4,059 |
2,016 |
$34K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,116 |
3,087 |
$21K |
| 99205 |
Prolong outpt/office vis |
103 |
103 |
$16K |
| 99215 |
Prolong outpt/office vis |
83 |
83 |
$10K |
| 81025 |
|
1,931 |
1,859 |
$5K |
| 81002 |
|
2,688 |
2,590 |
$4K |
| 93000 |
|
183 |
181 |
$4K |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
484 |
461 |
$2K |
| 99051 |
|
311 |
301 |
$840.74 |
| 87807 |
|
89 |
88 |
$733.89 |
| 99173 |
|
173 |
170 |
$577.11 |
| 29540 |
|
23 |
12 |
$436.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
28 |
28 |
$133.92 |
| 82962 |
|
39 |
39 |
$60.32 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
13 |
13 |
$57.96 |
| 85018 |
|
28 |
28 |
$52.94 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
14 |
13 |
$31.72 |
| 3075F |
|
1,064 |
1,035 |
$0.00 |
| 3079F |
|
2,114 |
2,037 |
$0.00 |
| 3074F |
|
4,116 |
3,862 |
$0.00 |
| 3080F |
|
1,827 |
1,758 |
$0.00 |
| 3077F |
|
1,345 |
1,303 |
$0.00 |
| 3078F |
|
2,595 |
2,486 |
$0.00 |