| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,189 |
956 |
$41K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
271 |
240 |
$21K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
520 |
447 |
$20K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
193 |
169 |
$14K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
988 |
427 |
$12K |
| 87428 |
|
160 |
145 |
$12K |
| S8301 |
Infection control supplies, not otherwise specified |
1,468 |
1,140 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
143 |
130 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
131 |
111 |
$11K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
827 |
394 |
$8K |
| 99429 |
|
116 |
102 |
$3K |
| 90461 |
|
181 |
120 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
154 |
132 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
32 |
28 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
175 |
114 |
$1K |
| 97169 |
|
27 |
23 |
$724.50 |
| 99000 |
|
51 |
44 |
$458.85 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
19 |
19 |
$284.24 |
| 96161 |
|
138 |
118 |
$216.25 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
17 |
12 |
$157.41 |
| 90619 |
|
16 |
12 |
$3.70 |
| 90670 |
|
45 |
42 |
$0.00 |
| 90648 |
|
70 |
59 |
$0.00 |
| 90710 |
|
18 |
13 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 97802 |
|
424 |
372 |
$0.00 |
| 90651 |
|
64 |
55 |
$0.00 |
| 90660 |
|
67 |
67 |
$0.00 |
| D1208 |
Topical application of fluoride, excluding varnish |
56 |
52 |
$0.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
424 |
372 |
$0.00 |
| 90686 |
|
48 |
48 |
$0.00 |
| 90723 |
|
41 |
38 |
$0.00 |
| 90620 |
|
17 |
14 |
$0.00 |
| 90696 |
|
17 |
12 |
$0.00 |