| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,889 |
1,635 |
$82K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
1,962 |
1,477 |
$39K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,776 |
1,426 |
$29K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,324 |
904 |
$27K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
472 |
305 |
$17K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,163 |
1,614 |
$17K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
329 |
272 |
$12K |
| 90461 |
|
235 |
197 |
$7K |
| 99442 |
|
167 |
144 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
149 |
126 |
$5K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
371 |
276 |
$4K |
| 87807 |
|
590 |
462 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
56 |
52 |
$2K |
| 99215 |
Prolong outpt/office vis |
42 |
29 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
110 |
98 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
106 |
83 |
$2K |
| 90671 |
|
55 |
51 |
$1K |
| 99383 |
|
38 |
26 |
$1K |
| 99382 |
|
40 |
25 |
$1K |
| 83655 |
|
183 |
125 |
$823.46 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
20 |
14 |
$706.29 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
28 |
16 |
$652.10 |
| 96127 |
|
244 |
200 |
$637.60 |
| 36416 |
|
307 |
217 |
$351.94 |
| 85018 |
|
388 |
277 |
$335.29 |
| 90670 |
|
36 |
28 |
$300.00 |
| 90680 |
|
49 |
45 |
$240.00 |
| 90698 |
|
51 |
47 |
$180.00 |
| 96161 |
|
66 |
58 |
$119.38 |
| 81002 |
|
84 |
62 |
$90.09 |
| 96160 |
|
63 |
36 |
$85.09 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
32 |
28 |
$53.10 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
214 |
173 |
$30.37 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
63 |
48 |
$23.98 |
| 99071 |
|
68 |
50 |
$0.00 |
| 81479 |
Unlisted molecular pathology procedure |
47 |
30 |
$0.00 |
| S9470 |
Nutritional counseling, dietitian visit |
18 |
12 |
$0.00 |
| 90710 |
|
17 |
13 |
$0.00 |