| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,765 |
4,773 |
$245K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
1,133 |
1,014 |
$45K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
356 |
348 |
$27K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,456 |
1,068 |
$26K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,529 |
754 |
$20K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
2,696 |
2,372 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
312 |
283 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
133 |
129 |
$11K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
332 |
292 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
91 |
91 |
$8K |
| 99050 |
|
429 |
314 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
67 |
64 |
$5K |
| 99051 |
|
308 |
261 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
27 |
27 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
130 |
104 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
60 |
55 |
$763.95 |
| 90461 |
|
75 |
61 |
$629.28 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
47 |
45 |
$596.25 |
| 0071A |
|
15 |
14 |
$350.00 |
| 87807 |
|
27 |
24 |
$297.00 |
| 96160 |
|
46 |
46 |
$63.00 |
| 97802 |
|
759 |
733 |
$0.23 |
| 90686 |
|
54 |
53 |
$0.19 |
| 90677 |
|
13 |
13 |
$0.03 |
| 90658 |
|
173 |
164 |
$0.02 |
| 90648 |
|
12 |
12 |
$0.00 |
| 90734 |
|
13 |
12 |
$0.00 |
| 90670 |
|
28 |
28 |
$0.00 |
| 91307 |
|
18 |
14 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
210 |
205 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
12 |
12 |
$0.00 |