| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
582 |
538 |
$29K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
355 |
347 |
$10K |
| 92552 |
|
95 |
95 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
26 |
26 |
$869.66 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$724.36 |
| 99072 |
|
144 |
132 |
$375.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
25 |
25 |
$165.61 |
| 99173 |
|
13 |
13 |
$32.10 |