| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
206 |
115 |
$14K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
87 |
59 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
72 |
35 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
23 |
12 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
76 |
75 |
$93.75 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
28 |
28 |
$62.46 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
12 |
12 |
$45.68 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
128 |
117 |
$35.33 |
| 94760 |
|
204 |
195 |
$21.18 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
69 |
69 |
$0.00 |
| 99401 |
|
143 |
140 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
147 |
82 |
$0.00 |
| 99051 |
|
31 |
31 |
$0.00 |