| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,097 |
5,795 |
$283K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
3,781 |
3,373 |
$157K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
8,620 |
3,818 |
$115K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,535 |
1,390 |
$87K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
1,653 |
1,443 |
$67K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,403 |
2,610 |
$62K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
636 |
624 |
$55K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
493 |
485 |
$45K |
| S8301 |
Infection control supplies, not otherwise specified |
3,509 |
2,963 |
$26K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,171 |
1,107 |
$16K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
119 |
117 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
373 |
334 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
103 |
101 |
$9K |
| 87807 |
|
548 |
487 |
$6K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
447 |
317 |
$4K |
| 90480 |
|
131 |
124 |
$4K |
| 90461 |
|
848 |
703 |
$4K |
| 0071A |
|
79 |
79 |
$3K |
| 99001 |
|
776 |
650 |
$3K |
| 0072A |
|
58 |
58 |
$3K |
| 83655 |
|
197 |
197 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
173 |
173 |
$2K |
| 0081A |
|
38 |
38 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
66 |
66 |
$1K |
| 0002A |
|
16 |
16 |
$640.00 |
| 0001A |
|
16 |
16 |
$600.00 |
| 0073A |
|
13 |
13 |
$520.00 |
| 0154A |
|
13 |
13 |
$520.00 |
| 96160 |
|
157 |
156 |
$370.92 |
| 86580 |
|
49 |
49 |
$368.62 |
| 81002 |
|
63 |
59 |
$178.12 |
| 90686 |
|
1,783 |
1,766 |
$0.71 |
| 90670 |
|
54 |
54 |
$0.00 |
| 91300 |
|
35 |
35 |
$0.00 |
| 91308 |
|
46 |
44 |
$0.00 |
| 91307 |
|
198 |
172 |
$0.00 |
| 91315 |
|
14 |
13 |
$0.00 |
| 90698 |
|
52 |
51 |
$0.00 |
| 91318 |
|
20 |
16 |
$0.00 |
| 90656 |
|
182 |
181 |
$0.00 |
| 91319 |
|
15 |
12 |
$0.00 |
| 90680 |
|
13 |
13 |
$0.00 |
| 90651 |
|
13 |
13 |
$0.00 |
| 90677 |
|
26 |
25 |
$0.00 |