| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
21,373 |
16,959 |
$2.88M |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,293 |
2,987 |
$65K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
509 |
410 |
$65K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
2,370 |
2,160 |
$57K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
4,229 |
3,831 |
$53K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
212 |
184 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,656 |
9,601 |
$4K |
| 81003 |
|
1,317 |
1,165 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
511 |
485 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
650 |
611 |
$2K |
| 86308 |
|
320 |
296 |
$2K |
| 87428 |
|
37 |
33 |
$2K |
| 90651 |
|
95 |
83 |
$1K |
| 90686 |
|
114 |
109 |
$859.58 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,979 |
3,343 |
$765.04 |
| 81025 |
|
252 |
227 |
$657.98 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,237 |
1,100 |
$476.35 |
| 90734 |
|
56 |
54 |
$432.00 |
| 74240 |
|
12 |
12 |
$352.22 |
| 87807 |
|
30 |
26 |
$275.00 |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
16 |
14 |
$194.84 |
| 71046 |
Radiologic examination, chest; 2 views |
17 |
13 |
$171.22 |
| 85018 |
|
61 |
53 |
$153.00 |
| G0477 |
Drug test(s), presumptive, any number of drug classes; any number of devices or procedures, (e.g., immunoassay) capable of being read by direct optical observation only (e.g., dipsticks, cups, cards, cartridges), includes sample validation when performed, per date of service |
18 |
14 |
$145.60 |
| 90619 |
|
13 |
13 |
$104.00 |
| 90715 |
|
12 |
12 |
$88.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
1,192 |
980 |
$57.33 |
| J0702 |
Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg |
518 |
413 |
$21.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
284 |
235 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
68 |
57 |
$0.00 |
| 99383 |
|
19 |
14 |
$0.00 |