| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
737 |
719 |
$33K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
359 |
354 |
$21K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
279 |
262 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
387 |
372 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
25 |
25 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
51 |
50 |
$622.88 |
| 90670 |
|
55 |
54 |
$225.00 |
| 96161 |
|
30 |
29 |
$64.99 |
| 3074F |
|
254 |
250 |
$0.02 |
| 3078F |
|
240 |
236 |
$0.02 |
| 1036F |
|
200 |
193 |
$0.00 |
| 3008F |
|
690 |
675 |
$0.00 |
| 90686 |
|
38 |
38 |
$0.00 |
| 1159F |
|
34 |
33 |
$0.00 |
| 3725F |
|
85 |
83 |
$0.00 |
| 1160F |
|
35 |
34 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |