| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
13,073 |
9,735 |
$1.16M |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
267 |
241 |
$35.33 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
519 |
252 |
$31.30 |
| 81003 |
|
577 |
383 |
$2.18 |
| 99173 |
|
178 |
156 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
71 |
61 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
302 |
264 |
$0.00 |
| 0502F |
|
233 |
147 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
79 |
77 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
17 |
12 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
39 |
25 |
$0.00 |
| 90633 |
|
15 |
12 |
$0.00 |
| 90670 |
|
24 |
24 |
$0.00 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
356 |
290 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
475 |
411 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
433 |
368 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,837 |
6,212 |
$0.00 |
| J1040 |
Injection, methylprednisolone acetate, 80 mg |
62 |
56 |
$0.00 |
| 87428 |
|
187 |
171 |
$0.00 |
| 90686 |
|
94 |
87 |
$0.00 |
| 90651 |
|
29 |
19 |
$0.00 |
| 87807 |
|
16 |
15 |
$0.00 |