| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
93 |
63 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
91 |
58 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
78 |
48 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
481 |
177 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
71 |
36 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
101 |
52 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
25 |
17 |
$1K |
| 92551 |
|
224 |
143 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
42 |
19 |
$723.68 |
| 90461 |
|
140 |
77 |
$450.80 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
56 |
15 |
$305.80 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
60 |
28 |
$291.69 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
23 |
20 |
$234.78 |
| 90710 |
|
25 |
13 |
$0.06 |
| 90620 |
|
22 |
13 |
$0.04 |
| 90734 |
|
34 |
18 |
$0.03 |
| 90670 |
|
49 |
28 |
$0.02 |
| 99173 |
|
116 |
93 |
$0.00 |
| 90651 |
|
41 |
21 |
$0.00 |
| 90696 |
|
27 |
15 |
$0.00 |
| 90698 |
|
24 |
12 |
$0.00 |
| 90688 |
|
44 |
35 |
$0.00 |