| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
10,758 |
8,630 |
$1.46M |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
197 |
160 |
$27K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,058 |
5,180 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,641 |
1,381 |
$2K |
| 80305 |
|
60 |
59 |
$607.26 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
18 |
15 |
$396.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
16 |
16 |
$192.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$168.00 |
| 90686 |
|
22 |
17 |
$112.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
117 |
106 |
$102.32 |
| 81002 |
|
34 |
34 |
$96.00 |
| 99215 |
Prolong outpt/office vis |
812 |
728 |
$90.70 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
34 |
33 |
$25.00 |
| 99205 |
Prolong outpt/office vis |
18 |
16 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
118 |
113 |
$0.00 |