| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
11,402 |
8,693 |
$936K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
325 |
277 |
$29K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
434 |
387 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
438 |
170 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,403 |
4,189 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
330 |
291 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,025 |
2,432 |
$3K |
| 81003 |
|
992 |
891 |
$3K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
157 |
107 |
$1K |
| 82570 |
|
225 |
206 |
$1K |
| 82044 |
|
228 |
207 |
$582.65 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
58 |
40 |
$574.00 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
17 |
17 |
$374.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
12 |
12 |
$347.64 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
36 |
29 |
$168.57 |
| 81025 |
|
67 |
57 |
$167.98 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
147 |
122 |
$106.46 |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
21 |
17 |
$34.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
388 |
274 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
404 |
283 |
$0.00 |
| 1036F |
|
127 |
95 |
$0.00 |
| 3075F |
|
25 |
19 |
$0.00 |
| 4010F |
|
70 |
49 |
$0.00 |
| 3008F |
|
201 |
154 |
$0.00 |
| 3079F |
|
54 |
39 |
$0.00 |
| 3066F |
|
62 |
43 |
$0.00 |
| 3074F |
|
145 |
109 |
$0.00 |
| 1160F |
|
204 |
155 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
41 |
25 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
92 |
65 |
$0.00 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
41 |
38 |
$0.00 |
| 1159F |
|
204 |
155 |
$0.00 |
| 3078F |
|
111 |
81 |
$0.00 |