| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,774 |
2,332 |
$94K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
430 |
391 |
$30K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
427 |
370 |
$30K |
| S8301 |
Infection control supplies, not otherwise specified |
3,886 |
2,894 |
$30K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,696 |
954 |
$23K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
519 |
409 |
$22K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
971 |
802 |
$20K |
| 87428 |
|
261 |
242 |
$11K |
| 90461 |
|
866 |
596 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
166 |
93 |
$8K |
| 92567 |
|
483 |
427 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
259 |
245 |
$3K |
| 87430 |
|
131 |
118 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
134 |
58 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
42 |
35 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
345 |
312 |
$1K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
161 |
78 |
$1K |
| 81003 |
|
134 |
113 |
$219.41 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
25 |
12 |
$172.65 |
| 92551 |
|
15 |
15 |
$147.30 |
| 87807 |
|
32 |
26 |
$145.47 |
| 97802 |
|
668 |
496 |
$57.82 |
| 90686 |
|
99 |
85 |
$18.45 |
| 90680 |
|
89 |
81 |
$0.00 |
| 90697 |
|
17 |
16 |
$0.00 |
| 90723 |
|
13 |
13 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| 90670 |
|
300 |
265 |
$0.00 |
| 99401 |
|
496 |
354 |
$0.00 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
146 |
65 |
$0.00 |
| 90648 |
|
72 |
70 |
$0.00 |
| 90710 |
|
14 |
14 |
$0.00 |
| 99173 |
|
27 |
25 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |