| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99215 |
Prolong outpt/office vis |
1,163 |
1,032 |
$87K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
930 |
900 |
$68K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
802 |
744 |
$60K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
705 |
619 |
$47K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
963 |
833 |
$45K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
884 |
784 |
$43K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
953 |
841 |
$32K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,847 |
1,025 |
$21K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
248 |
241 |
$19K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
652 |
619 |
$18K |
| S8301 |
Infection control supplies, not otherwise specified |
1,609 |
1,347 |
$11K |
| 99429 |
|
231 |
224 |
$8K |
| 90461 |
|
1,305 |
659 |
$6K |
| 99381 |
|
91 |
80 |
$6K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
528 |
489 |
$3K |
| 83655 |
|
244 |
230 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
32 |
30 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
47 |
44 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
21 |
20 |
$2K |
| 99383 |
|
15 |
15 |
$1K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
20 |
19 |
$1K |
| 99384 |
|
12 |
12 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
75 |
68 |
$976.79 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
25 |
25 |
$447.72 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
30 |
14 |
$389.20 |
| S3620 |
Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d; phenylalanine (pku); and thyroxine, total) |
21 |
14 |
$350.00 |
| 83789 |
|
21 |
14 |
$202.50 |
| 99072 |
|
144 |
117 |
$50.00 |
| 84030 |
|
21 |
14 |
$46.20 |
| 90686 |
|
296 |
285 |
$17.51 |
| 90680 |
|
159 |
150 |
$0.01 |
| 90716 |
|
140 |
132 |
$0.01 |
| 90744 |
|
184 |
172 |
$0.01 |
| 90670 |
|
386 |
359 |
$0.01 |
| 90707 |
|
156 |
149 |
$0.01 |
| 90698 |
|
261 |
239 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 90633 |
|
180 |
166 |
$0.00 |
| 90700 |
|
54 |
53 |
$0.00 |
| 90648 |
|
15 |
14 |
$0.00 |