| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
9,072 |
7,870 |
$1.49M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
228 |
227 |
$37K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
228 |
227 |
$36K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
235 |
227 |
$35K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
68 |
68 |
$12K |
| 81002 |
|
1,090 |
977 |
$10K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
93 |
90 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,050 |
659 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
125 |
53 |
$841.63 |
| 90734 |
|
109 |
104 |
$486.90 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
69 |
59 |
$295.11 |
| 90670 |
|
124 |
123 |
$165.71 |
| 90715 |
|
40 |
37 |
$160.06 |
| 90461 |
|
840 |
406 |
$0.00 |
| 3078F |
|
198 |
197 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
224 |
216 |
$0.00 |
| 90710 |
|
28 |
28 |
$0.00 |
| 3008F |
|
372 |
368 |
$0.00 |
| 90694 |
|
13 |
12 |
$0.00 |
| 3074F |
|
235 |
232 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
289 |
283 |
$0.00 |
| 90686 |
|
63 |
60 |
$0.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
12 |
12 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
12 |
12 |
$0.00 |