| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,984 |
3,788 |
$326K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
726 |
712 |
$80K |
| T1015 |
Clinic visit/encounter, all-inclusive |
1,444 |
286 |
$68K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
534 |
526 |
$57K |
| 99284 |
Emergency department visit for the evaluation and management, high severity |
136 |
127 |
$18K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
169 |
161 |
$13K |
| 99285 |
Emergency department visit for the evaluation and management, high severity with immediate threat to life |
66 |
64 |
$13K |
| 96365 |
Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour |
249 |
117 |
$10K |
| 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 |
85 |
81 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,277 |
1,244 |
$8K |
| 99050 |
|
66 |
63 |
$7K |
| 87070 |
|
942 |
926 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
49 |
49 |
$5K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
302 |
297 |
$5K |
| 80053 |
Comprehensive metabolic panel |
225 |
212 |
$3K |
| 74177 |
Computed tomography, abdomen and pelvis; with contrast material |
12 |
12 |
$3K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
253 |
239 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
37 |
36 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17 |
17 |
$1K |
| 84443 |
Thyroid stimulating hormone (TSH) |
30 |
30 |
$766.92 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
56 |
53 |
$736.66 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
60 |
42 |
$598.59 |
| Q9967 |
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml |
58 |
57 |
$574.00 |
| 81002 |
|
137 |
134 |
$451.73 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
60 |
59 |
$444.24 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
33 |
32 |
$364.52 |
| 71046 |
Radiologic examination, chest; 2 views |
12 |
12 |
$196.02 |
| 80061 |
Lipid panel |
12 |
12 |
$181.72 |
| 85610 |
|
32 |
28 |
$146.32 |
| 85730 |
|
16 |
15 |
$141.60 |
| 73630 |
|
14 |
13 |
$127.77 |
| 81003 |
|
28 |
26 |
$102.48 |
| 71045 |
Radiologic examination, chest; single view |
12 |
12 |
$95.70 |
| 83690 |
|
16 |
15 |
$94.40 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
52 |
51 |
$32.56 |
| 87147 |
|
12 |
12 |
$31.20 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
24 |
24 |
$3.20 |
| J1756 |
Injection, iron sucrose, 1 mg |
278 |
124 |
$0.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
106 |
75 |
$0.00 |