| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
922 |
535 |
$26K |
| 99454 |
|
784 |
678 |
$8K |
| 99458 |
|
854 |
750 |
$8K |
| 99457 |
|
858 |
754 |
$6K |
| 99215 |
Prolong outpt/office vis |
125 |
65 |
$3K |
| 99490 |
Ccm add 20min |
314 |
264 |
$2K |
| G2058 |
Chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure). (do not report g2058 for care management services of less than 20 minutes additional to the first 20 minutes of chronic care management services during a calendar month). (use g2058 in conjunction with 99490). (do not report 99490, g2058 in the same calendar month as 99487, 99489, 99491)). |
153 |
150 |
$1K |
| 99439 |
|
160 |
123 |
$863.79 |
| 99487 |
Ccm add 20min |
89 |
77 |
$789.27 |
| 99489 |
Ccm add 20min |
86 |
76 |
$404.56 |
| 99491 |
Ccm add 20min |
35 |
29 |
$307.92 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
23 |
22 |
$291.14 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
17 |
16 |
$248.60 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
20 |
15 |
$219.26 |
| J3415 |
Injection, pyridoxine hcl, 100 mg |
101 |
27 |
$165.21 |
| J0132 |
Injection, acetylcysteine, 100 mg |
105 |
28 |
$23.50 |
| J3420 |
Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg |
42 |
13 |
$16.71 |
| 99070 |
|
165 |
26 |
$0.00 |