| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,597 |
9,977 |
$399K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,950 |
1,704 |
$95K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
6,410 |
5,670 |
$87K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,364 |
3,096 |
$86K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,028 |
1,020 |
$83K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
713 |
692 |
$61K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
4,377 |
1,983 |
$60K |
| 87428 |
|
1,779 |
1,554 |
$60K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,250 |
1,146 |
$55K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
584 |
566 |
$46K |
| S8301 |
Infection control supplies, not otherwise specified |
5,232 |
4,114 |
$43K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
788 |
714 |
$33K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
352 |
341 |
$32K |
| 90461 |
|
1,279 |
1,051 |
$8K |
| 87077 |
|
585 |
563 |
$3K |
| 99000 |
|
285 |
274 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
287 |
208 |
$3K |
| 97169 |
|
68 |
67 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
119 |
111 |
$2K |
| 99001 |
|
330 |
204 |
$936.67 |
| 90670 |
|
227 |
227 |
$222.41 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
18 |
13 |
$221.20 |
| 96160 |
|
37 |
37 |
$88.45 |
| 81002 |
|
25 |
14 |
$47.61 |
| 90686 |
|
675 |
667 |
$39.44 |
| 94760 |
|
211 |
200 |
$27.92 |
| 90744 |
|
29 |
29 |
$27.87 |
| 90696 |
|
12 |
12 |
$0.00 |
| 90651 |
|
99 |
99 |
$0.00 |
| 90698 |
|
109 |
109 |
$0.00 |
| 90680 |
|
25 |
25 |
$0.00 |
| 36416 |
|
13 |
12 |
$0.00 |
| 90656 |
|
15 |
15 |
$0.00 |
| 99072 |
|
150 |
147 |
$0.00 |
| 90633 |
|
81 |
81 |
$0.00 |
| 90671 |
|
131 |
131 |
$0.00 |
| 90734 |
|
32 |
32 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |