| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
8,556 |
7,511 |
$3.00M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21,841 |
11,205 |
$808K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
2,164 |
1,947 |
$77K |
| 99383 |
|
466 |
466 |
$33K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
712 |
709 |
$33K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
552 |
549 |
$26K |
| 99382 |
|
386 |
385 |
$24K |
| 92551 |
|
1,727 |
1,722 |
$24K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
283 |
283 |
$23K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
309 |
308 |
$17K |
| 99381 |
|
189 |
185 |
$12K |
| 95957 |
|
75 |
75 |
$11K |
| 99173 |
|
1,676 |
1,671 |
$8K |
| 90670 |
|
661 |
660 |
$7K |
| 92653 |
|
75 |
75 |
$7K |
| 90648 |
|
633 |
631 |
$7K |
| 95816 |
|
74 |
74 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
166 |
154 |
$6K |
| 90658 |
|
407 |
406 |
$5K |
| 90723 |
|
385 |
383 |
$4K |
| 90680 |
|
386 |
385 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
96 |
96 |
$4K |
| 95930 |
|
86 |
86 |
$4K |
| 90633 |
|
308 |
307 |
$3K |
| 90707 |
|
216 |
216 |
$2K |
| 90716 |
|
211 |
211 |
$2K |
| 99384 |
|
27 |
27 |
$2K |
| 92650 |
|
59 |
59 |
$2K |
| 90700 |
|
163 |
163 |
$2K |
| 90657 |
|
150 |
148 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
16 |
$1K |
| 90649 |
|
69 |
69 |
$902.50 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
128 |
121 |
$693.16 |
| 90715 |
|
52 |
52 |
$585.00 |
| 86328 |
|
12 |
12 |
$542.76 |
| 90713 |
|
46 |
46 |
$508.50 |
| 90734 |
|
39 |
39 |
$436.50 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
75 |
62 |
$420.42 |
| 69210 |
|
13 |
13 |
$265.00 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
30 |
25 |
$142.66 |
| 90696 |
|
12 |
12 |
$135.00 |
| 90744 |
|
12 |
12 |
$130.50 |
| 85018 |
|
62 |
61 |
$89.64 |
| 81002 |
|
44 |
41 |
$61.92 |
| 99401 |
|
22 |
22 |
$0.00 |
| 94760 |
|
26 |
24 |
$0.00 |
| 99000 |
|
135 |
134 |
$0.00 |