| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14,545 |
12,093 |
$427K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,780 |
3,870 |
$197K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
679 |
431 |
$13K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,283 |
702 |
$10K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
225 |
197 |
$9K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
5,410 |
3,111 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
329 |
281 |
$6K |
| M0243 |
Intravenous infusion or subcutaneous injection, casirivimab and imdevimab includes infusion or injection, and post administration monitoring |
42 |
25 |
$6K |
| 99215 |
Prolong outpt/office vis |
93 |
70 |
$5K |
| 86328 |
|
230 |
130 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
492 |
400 |
$4K |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
1,488 |
1,264 |
$3K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
92 |
67 |
$2K |
| 81002 |
|
458 |
341 |
$571.29 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,521 |
1,333 |
$550.30 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
28 |
23 |
$296.94 |
| 90658 |
|
25 |
22 |
$185.76 |
| 81025 |
|
32 |
25 |
$115.64 |
| 96127 |
|
68 |
65 |
$90.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
17 |
13 |
$78.93 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
552 |
418 |
$42.77 |
| 81003 |
|
42 |
24 |
$38.05 |
| J7030 |
Infusion, normal saline solution , 1000 cc |
21 |
14 |
$30.28 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
310 |
199 |
$0.36 |
| Q0244 |
Injection, casirivimab and imdevimab, 1200 mg |
20 |
12 |
$0.00 |