| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,921 |
3,469 |
$176K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,052 |
875 |
$25K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,724 |
1,585 |
$22K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
263 |
256 |
$21K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
395 |
375 |
$16K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,158 |
555 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
298 |
280 |
$15K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,098 |
820 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
170 |
170 |
$14K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
1,298 |
1,188 |
$8K |
| 92567 |
|
833 |
781 |
$8K |
| 87428 |
|
161 |
143 |
$8K |
| 94014 |
|
136 |
131 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
56 |
56 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
44 |
38 |
$3K |
| 87807 |
|
227 |
221 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
212 |
155 |
$2K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
47 |
47 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
13 |
13 |
$831.95 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
211 |
154 |
$338.18 |
| 81003 |
|
70 |
62 |
$127.08 |
| 86308 |
|
29 |
28 |
$124.39 |
| 90461 |
|
303 |
260 |
$6.71 |
| 90656 |
|
52 |
52 |
$0.01 |
| 90651 |
|
13 |
13 |
$0.00 |
| 90686 |
|
13 |
13 |
$0.00 |
| 90671 |
|
57 |
53 |
$0.00 |