| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,236 |
5,822 |
$197K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,222 |
1,013 |
$28K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,279 |
781 |
$9K |
| 71046 |
Radiologic examination, chest; 2 views |
467 |
402 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
284 |
224 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
317 |
264 |
$2K |
| 99406 |
|
581 |
479 |
$2K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
30 |
14 |
$1K |
| 90756 |
|
127 |
121 |
$938.59 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
52 |
25 |
$841.82 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
31 |
12 |
$615.87 |
| 90674 |
|
78 |
78 |
$597.84 |
| J3301 |
Injection, triamcinolone acetonide, not otherwise specified, 10 mg |
215 |
181 |
$542.10 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
41 |
37 |
$363.02 |
| 87503 |
|
30 |
14 |
$278.10 |
| 72110 |
|
16 |
16 |
$254.01 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
231 |
189 |
$252.42 |
| 81002 |
|
291 |
232 |
$223.06 |
| G0008 |
Administration of influenza virus vaccine |
131 |
130 |
$165.85 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
45 |
36 |
$161.42 |
| Q3014 |
Telehealth originating site facility fee |
18 |
17 |
$89.87 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
36 |
27 |
$67.57 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
21 |
18 |
$66.79 |
| 36415 |
Collection of venous blood by venipuncture |
124 |
117 |
$41.55 |
| 85610 |
|
73 |
66 |
$27.90 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
124 |
109 |
$22.42 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
19 |
13 |
$17.76 |
| J1580 |
Injection, garamycin, gentamicin, up to 80 mg |
19 |
15 |
$5.94 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
56 |
51 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
13 |
12 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
18 |
18 |
$0.00 |