| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
223 |
222 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
61 |
61 |
$7K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
66 |
66 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
55 |
55 |
$3K |
| 90461 |
|
56 |
56 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
50 |
50 |
$2K |
| 90686 |
|
92 |
92 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
57 |
57 |
$850.47 |
| 96127 |
|
117 |
117 |
$654.12 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$560.04 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
14 |
$196.75 |
| 99174 |
|
27 |
27 |
$194.67 |
| 99173 |
|
27 |
27 |
$105.86 |
| 96160 |
|
13 |
13 |
$40.04 |