| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
567 |
544 |
$22K |
| S8301 |
Infection control supplies, not otherwise specified |
742 |
702 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
80 |
80 |
$7K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
167 |
165 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
73 |
70 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
48 |
48 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
458 |
201 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
107 |
103 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
41 |
40 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
262 |
129 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
17 |
17 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
161 |
134 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
160 |
156 |
$1K |
| 99429 |
|
31 |
31 |
$957.69 |
| 90461 |
|
110 |
95 |
$863.76 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
14 |
14 |
$379.96 |
| 96160 |
|
32 |
26 |
$41.62 |
| 90686 |
|
88 |
88 |
$24.00 |
| 90670 |
|
25 |
25 |
$10.00 |