| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,269 |
824 |
$48K |
| T1015 |
Clinic visit/encounter, all-inclusive |
201 |
156 |
$23K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
163 |
94 |
$9K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
196 |
131 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
318 |
113 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
324 |
144 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
122 |
75 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$311.76 |
| 36415 |
Collection of venous blood by venipuncture |
168 |
107 |
$132.80 |
| 81003 |
|
49 |
29 |
$54.00 |
| 96127 |
|
78 |
61 |
$28.71 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
63 |
28 |
$22.27 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
80 |
43 |
$10.18 |
| 1126F |
|
735 |
438 |
$0.00 |
| 3008F |
|
822 |
490 |
$0.00 |
| 1036F |
|
640 |
377 |
$0.00 |
| 3079F |
|
66 |
40 |
$0.00 |
| 3074F |
|
512 |
295 |
$0.00 |
| 3700F |
|
14 |
12 |
$0.00 |
| 94760 |
|
38 |
17 |
$0.00 |
| G8417 |
Bmi is documented above normal parameters and a follow-up plan is documented |
213 |
139 |
$0.00 |
| 1160F |
|
712 |
432 |
$0.00 |
| 3078F |
|
448 |
255 |
$0.00 |
| 1159F |
|
708 |
431 |
$0.00 |
| 1026F |
|
250 |
144 |
$0.00 |
| 3725F |
|
130 |
83 |
$0.00 |