| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,777 |
4,192 |
$189K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
2,707 |
2,172 |
$99K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,688 |
3,083 |
$46K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,703 |
1,257 |
$32K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,470 |
615 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
276 |
259 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
135 |
135 |
$10K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,278 |
1,150 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
119 |
118 |
$7K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
260 |
240 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
127 |
125 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
74 |
74 |
$5K |
| 87807 |
|
261 |
226 |
$3K |
| S8301 |
Infection control supplies, not otherwise specified |
76 |
68 |
$1K |
| 90461 |
|
128 |
111 |
$749.50 |
| 81003 |
|
440 |
409 |
$748.06 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
60 |
60 |
$390.72 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
29 |
29 |
$357.75 |
| 99000 |
|
16 |
16 |
$162.00 |
| 96161 |
|
27 |
27 |
$39.36 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
29 |
29 |
$1.25 |
| 90686 |
|
58 |
57 |
$0.00 |
| 90723 |
|
12 |
12 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
13 |
13 |
$0.00 |
| 90670 |
|
69 |
68 |
$0.00 |
| 90648 |
|
28 |
28 |
$0.00 |