| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,957 |
4,098 |
$244K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,065 |
948 |
$81K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
631 |
576 |
$45K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
388 |
360 |
$26K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,356 |
1,217 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
347 |
264 |
$24K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
305 |
279 |
$24K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
441 |
344 |
$16K |
| 99173 |
|
1,723 |
1,560 |
$13K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
758 |
666 |
$11K |
| 96127 |
|
718 |
676 |
$10K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
211 |
198 |
$5K |
| 90686 |
|
219 |
206 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
74 |
72 |
$2K |
| 81003 |
|
900 |
773 |
$2K |
| D1206 |
Topical application of fluoride varnish |
72 |
43 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
129 |
109 |
$1K |
| 85018 |
|
495 |
430 |
$1K |
| 83655 |
|
81 |
71 |
$948.80 |
| 90651 |
|
50 |
49 |
$835.50 |
| 90698 |
|
49 |
43 |
$818.79 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
56 |
51 |
$697.12 |
| 90677 |
|
22 |
19 |
$565.65 |
| 90734 |
|
26 |
26 |
$434.46 |
| 90716 |
|
18 |
13 |
$300.78 |
| 90619 |
|
18 |
14 |
$300.78 |
| 90707 |
|
18 |
13 |
$300.78 |
| 90715 |
|
14 |
12 |
$233.94 |
| 90621 |
|
12 |
12 |
$200.52 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
44 |
39 |
$6.40 |
| 1036F |
|
427 |
412 |
$0.00 |
| 1220F |
|
373 |
364 |
$0.00 |
| 1003F |
|
662 |
525 |
$0.00 |
| 97803 |
|
98 |
90 |
$0.00 |