| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,602 |
3,422 |
$191K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
782 |
710 |
$64K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
536 |
510 |
$45K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
489 |
449 |
$22K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
103 |
100 |
$15K |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
408 |
385 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
724 |
697 |
$6K |
| 3074F |
|
2,165 |
2,096 |
$3K |
| 87428 |
|
98 |
98 |
$3K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
661 |
629 |
$733.20 |
| 96127 |
|
156 |
151 |
$568.29 |
| 1160F |
|
3,107 |
2,985 |
$324.02 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
12 |
12 |
$273.09 |
| 3078F |
|
1,692 |
1,643 |
$180.02 |
| 3075F |
|
27 |
27 |
$160.00 |
| 1125F |
|
1,155 |
1,113 |
$129.00 |
| 1126F |
|
1,168 |
1,135 |
$114.02 |
| 81002 |
|
63 |
57 |
$75.42 |
| 3079F |
|
282 |
276 |
$42.00 |
| 3077F |
|
12 |
12 |
$30.00 |
| J8499 |
Prescription drug, oral, non chemotherapeutic, nos |
13 |
12 |
$25.84 |
| 1159F |
|
1,513 |
1,448 |
$3.00 |
| 3288F |
|
3,350 |
3,230 |
$0.00 |
| 3725F |
|
2,578 |
2,479 |
$0.00 |
| G0382 |
Level 3 hospital emergency department visit provided in a type b emergency department; (the ed must meet at least one of the following requirements: (1) it is licensed by the state in which it is located under applicable state law as an emergency room or emergency department; (2) it is held out to the public (by name, posted signs, advertising, or other means) as a place that provides care for emergency medical conditions on an urgent basis without requiring a previously scheduled appointment; or (3) during the calendar year immediately preceding the calendar year in which a determination under 42 cfr 489.24 is being made, based on a representative sample of patient visits that occurred during that calendar year, it provides at least one-third of all of its outpatient visits for the treatment of emergency medical conditions on an urgent basis without requiring a previously scheduled appointment) |
204 |
183 |
$0.00 |
| 3008F |
|
1,817 |
1,749 |
$0.00 |
| 1111F |
|
634 |
611 |
$0.00 |
| 1170F |
|
915 |
877 |
$0.00 |
| 1157F |
|
384 |
372 |
$0.00 |