| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,126 |
1,081 |
$39K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
649 |
319 |
$8K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
296 |
290 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
70 |
70 |
$6K |
| S8301 |
Infection control supplies, not otherwise specified |
341 |
334 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
508 |
250 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
420 |
409 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
32 |
32 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
30 |
29 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
45 |
44 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
24 |
24 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
75 |
61 |
$568.06 |
| 99429 |
|
13 |
13 |
$444.08 |
| 90461 |
|
30 |
24 |
$100.65 |
| 96160 |
|
12 |
12 |
$27.00 |
| 96127 |
|
12 |
12 |
$0.00 |
| 90686 |
|
12 |
12 |
$0.00 |