| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,266 |
1,793 |
$112K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
541 |
505 |
$24K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,699 |
805 |
$24K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
273 |
261 |
$23K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
111 |
111 |
$9K |
| G9716 |
Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason |
432 |
430 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
470 |
226 |
$7K |
| S8301 |
Infection control supplies, not otherwise specified |
273 |
258 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
336 |
314 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
93 |
90 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
31 |
30 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
243 |
223 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
19 |
19 |
$1K |
| 81002 |
|
388 |
370 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$959.11 |
| 99050 |
|
46 |
43 |
$687.24 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
101 |
93 |
$625.56 |
| 99429 |
|
19 |
19 |
$608.04 |
| 92552 |
|
156 |
155 |
$589.64 |
| 97169 |
|
12 |
12 |
$500.00 |
| 96160 |
|
870 |
691 |
$470.48 |
| 99000 |
|
30 |
29 |
$311.04 |
| 87807 |
|
29 |
28 |
$306.90 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
15 |
15 |
$249.99 |
| 86580 |
|
12 |
12 |
$89.13 |
| S9441 |
Asthma education, non-physician provider, per session |
14 |
13 |
$62.00 |
| 90461 |
|
25 |
21 |
$40.26 |
| 90686 |
|
27 |
27 |
$0.27 |
| 99173 |
|
87 |
87 |
$0.00 |
| 99051 |
|
53 |
51 |
$0.00 |
| 3008F |
|
315 |
313 |
$0.00 |
| 3074F |
|
149 |
147 |
$0.00 |
| 2000F |
|
37 |
36 |
$0.00 |