| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,932 |
3,518 |
$138K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,002 |
889 |
$50K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,598 |
966 |
$30K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
290 |
279 |
$23K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
475 |
413 |
$18K |
| S8301 |
Infection control supplies, not otherwise specified |
1,614 |
1,378 |
$17K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
198 |
196 |
$16K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
265 |
238 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
671 |
592 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
630 |
291 |
$9K |
| 87428 |
|
170 |
163 |
$5K |
| 90461 |
|
573 |
492 |
$3K |
| 87077 |
|
122 |
112 |
$498.51 |
| 99000 |
|
41 |
40 |
$403.51 |
| 99001 |
|
109 |
81 |
$396.01 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
20 |
15 |
$179.16 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
15 |
13 |
$99.02 |
| 81002 |
|
14 |
12 |
$34.88 |
| 94760 |
|
154 |
141 |
$27.19 |
| 90671 |
|
63 |
63 |
$0.00 |
| 90670 |
|
33 |
32 |
$0.00 |
| 90633 |
|
13 |
13 |
$0.00 |
| 90686 |
|
41 |
40 |
$0.00 |
| 90680 |
|
28 |
28 |
$0.00 |
| G8708 |
Patient not prescribed antibiotic |
58 |
41 |
$0.00 |
| 90698 |
|
16 |
16 |
$0.00 |