| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,585 |
2,540 |
$69K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,170 |
2,016 |
$11K |
| 99441 |
|
54 |
52 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
185 |
159 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
119 |
114 |
$962.15 |
| 96127 |
|
503 |
268 |
$748.79 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
304 |
304 |
$573.98 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
124 |
123 |
$513.83 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
571 |
570 |
$501.12 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
301 |
300 |
$453.90 |
| 87077 |
|
39 |
38 |
$328.93 |
| 90649 |
|
55 |
54 |
$265.50 |
| 90686 |
|
580 |
580 |
$214.57 |
| 90461 |
|
41 |
40 |
$137.61 |
| 90658 |
|
282 |
278 |
$79.59 |
| 94762 |
|
45 |
43 |
$23.58 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
88 |
86 |
$12.57 |
| 90670 |
|
57 |
57 |
$0.00 |
| 90713 |
|
88 |
88 |
$0.00 |
| 90700 |
|
144 |
142 |
$0.00 |
| 90648 |
|
48 |
48 |
$0.00 |
| 90672 |
|
12 |
12 |
$0.00 |
| 90660 |
|
26 |
26 |
$0.00 |