| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
17,646 |
14,591 |
$1.33M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,452 |
1,408 |
$122K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,267 |
1,247 |
$100K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,199 |
1,111 |
$97K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,023 |
1,015 |
$82K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,367 |
1,343 |
$35K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,940 |
1,889 |
$29K |
| 90686 |
|
664 |
662 |
$6K |
| 87807 |
|
351 |
349 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
622 |
313 |
$5K |
| 99000 |
|
237 |
232 |
$4K |
| 81002 |
|
224 |
220 |
$4K |
| 90672 |
|
239 |
238 |
$3K |
| 90651 |
|
547 |
547 |
$2K |
| 90619 |
|
35 |
35 |
$1K |
| 90697 |
|
87 |
85 |
$1K |
| 99381 |
|
15 |
15 |
$949.41 |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
105 |
105 |
$649.32 |
| 88720 |
|
20 |
13 |
$611.43 |
| 81025 |
|
37 |
37 |
$549.76 |
| 90633 |
|
643 |
642 |
$546.36 |
| 91307 |
|
16 |
16 |
$437.60 |
| 90698 |
|
729 |
721 |
$435.18 |
| 90700 |
|
116 |
115 |
$265.03 |
| 90621 |
|
65 |
65 |
$264.40 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
27 |
27 |
$185.52 |
| 90734 |
|
304 |
304 |
$176.88 |
| 87276 |
|
612 |
596 |
$112.68 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,947 |
3,861 |
$110.06 |
| 90710 |
|
296 |
296 |
$89.36 |
| 90648 |
|
67 |
67 |
$89.36 |
| 90744 |
|
528 |
520 |
$89.36 |
| 90715 |
|
152 |
152 |
$87.52 |
| 90680 |
|
643 |
635 |
$86.31 |
| 87275 |
|
612 |
596 |
$14.71 |
| 90461 |
|
4,179 |
2,200 |
$7.89 |
| 90670 |
|
1,201 |
1,192 |
$0.00 |
| 90685 |
|
46 |
45 |
$0.00 |
| 99173 |
|
62 |
61 |
$0.00 |
| 90681 |
|
12 |
12 |
$0.00 |
| 36416 |
|
75 |
74 |
$0.00 |
| 0240U |
|
135 |
134 |
$0.00 |
| 90696 |
|
140 |
140 |
$0.00 |
| 99441 |
|
14 |
14 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
12 |
12 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
49 |
32 |
$0.00 |