| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,131 |
1,901 |
$263K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
110 |
102 |
$20K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
45 |
45 |
$11K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
94 |
94 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
25 |
24 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
104 |
98 |
$3K |
| 80053 |
Comprehensive metabolic panel |
26 |
26 |
$1K |
| Q3014 |
Telehealth originating site facility fee |
67 |
53 |
$915.69 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
27 |
27 |
$885.60 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
30 |
30 |
$783.90 |
| 96127 |
|
14 |
12 |
$510.30 |
| 3008F |
|
12 |
12 |
$0.00 |
| 1159F |
|
13 |
12 |
$0.00 |