| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,506 |
3,366 |
$147K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,239 |
1,161 |
$125K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
832 |
811 |
$93K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
913 |
889 |
$92K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,225 |
1,127 |
$86K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
535 |
507 |
$52K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,144 |
1,099 |
$47K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
189 |
169 |
$16K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
222 |
155 |
$5K |
| 90671 |
|
14 |
13 |
$2K |
| 0071A |
|
41 |
39 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
36 |
32 |
$1K |
| 99429 |
|
131 |
83 |
$1K |
| 0072A |
|
24 |
24 |
$996.00 |
| 0002A |
|
20 |
20 |
$863.10 |
| 0001A |
|
19 |
19 |
$796.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
81 |
74 |
$718.84 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
43 |
42 |
$588.13 |
| 90473 |
|
25 |
24 |
$502.94 |
| 96127 |
|
83 |
82 |
$389.80 |
| 90672 |
|
109 |
107 |
$374.33 |
| 99173 |
|
64 |
63 |
$236.63 |
| 92551 |
|
63 |
62 |
$230.44 |
| 85018 |
|
67 |
65 |
$201.72 |
| 36415 |
Collection of venous blood by venipuncture |
96 |
92 |
$119.10 |
| 90686 |
|
1,265 |
1,227 |
$99.56 |
| 90620 |
|
38 |
38 |
$0.00 |
| 90647 |
|
29 |
26 |
$0.00 |
| 90651 |
|
72 |
68 |
$0.00 |
| 90723 |
|
28 |
26 |
$0.00 |
| 90734 |
|
59 |
56 |
$0.00 |
| 90670 |
|
103 |
100 |
$0.00 |
| 90633 |
|
18 |
18 |
$0.00 |