| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
421 |
404 |
$18K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
641 |
296 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
152 |
150 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
86 |
86 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
58 |
58 |
$4K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
18 |
18 |
$2K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
69 |
68 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$814.45 |
| 99050 |
|
12 |
12 |
$207.96 |
| 36416 |
|
29 |
29 |
$95.07 |
| 99173 |
|
25 |
25 |
$62.45 |
| 85018 |
|
28 |
28 |
$48.62 |
| 90677 |
|
128 |
128 |
$0.11 |
| 90633 |
|
46 |
46 |
$0.00 |
| 90697 |
|
98 |
98 |
$0.00 |
| 90656 |
|
21 |
21 |
$0.00 |
| 90680 |
|
82 |
82 |
$0.00 |