| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
248 |
213 |
$17K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
375 |
373 |
$12K |
| U0002 |
2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-cdc |
197 |
182 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
64 |
64 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
45 |
43 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
24 |
24 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
148 |
145 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
98 |
53 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$1K |
| 92587 |
|
47 |
47 |
$1K |
| 96160 |
|
274 |
255 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
75 |
74 |
$929.65 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
12 |
$837.59 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
16 |
16 |
$518.40 |
| 81003 |
|
94 |
94 |
$181.41 |
| 99072 |
|
154 |
150 |
$100.00 |
| 85018 |
|
27 |
27 |
$75.06 |
| 87081 |
|
16 |
16 |
$7.60 |
| 96127 |
|
86 |
64 |
$0.00 |
| 36416 |
|
30 |
30 |
$0.00 |
| 94760 |
|
27 |
21 |
$0.00 |
| 90686 |
|
66 |
66 |
$0.00 |
| 99173 |
|
12 |
12 |
$0.00 |