| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S9470 |
Nutritional counseling, dietitian visit |
756 |
675 |
$39K |
| 97802 |
|
688 |
636 |
$39K |
| 97803 |
|
1,095 |
974 |
$28K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
918 |
878 |
$10K |
| S8301 |
Infection control supplies, not otherwise specified |
625 |
615 |
$9K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
371 |
364 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
42 |
41 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
30 |
30 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
193 |
191 |
$902.85 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
19 |
19 |
$881.62 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
231 |
112 |
$713.44 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
76 |
73 |
$235.08 |
| 90461 |
|
45 |
32 |
$191.80 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
27 |
24 |
$146.52 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
51 |
51 |
$101.49 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
186 |
93 |
$97.30 |
| 96161 |
|
35 |
35 |
$58.50 |
| 99050 |
|
18 |
18 |
$0.00 |
| 99051 |
|
16 |
16 |
$0.00 |