| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,635 |
2,170 |
$92K |
| 87428 |
|
432 |
408 |
$24K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
644 |
615 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
57 |
57 |
$5K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
80 |
76 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
257 |
153 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
40 |
40 |
$3K |
| 87430 |
|
166 |
164 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
142 |
138 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
498 |
455 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
112 |
56 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
270 |
257 |
$1K |
| 81002 |
|
447 |
395 |
$1K |
| 0001A |
|
32 |
32 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
163 |
159 |
$1K |
| 0002A |
|
31 |
31 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
15 |
$892.09 |
| 82947 |
|
212 |
192 |
$658.80 |
| 84443 |
Thyroid stimulating hormone (TSH) |
25 |
25 |
$268.09 |
| 80061 |
Lipid panel |
13 |
13 |
$135.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
18 |
12 |
$117.60 |
| 90686 |
|
268 |
262 |
$0.00 |