| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
312 |
301 |
$26K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
242 |
236 |
$23K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
176 |
172 |
$13K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
531 |
288 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,166 |
1,067 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
50 |
50 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,913 |
1,551 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
78 |
70 |
$1K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
14 |
14 |
$610.00 |
| 90461 |
|
170 |
148 |
$100.91 |
| 97803 |
|
475 |
459 |
$0.00 |
| 99051 |
|
339 |
311 |
$0.00 |
| 87400 |
|
58 |
57 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
193 |
183 |
$0.00 |
| 90734 |
|
27 |
27 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| 90685 |
|
41 |
41 |
$0.00 |
| 86328 |
|
45 |
39 |
$0.00 |
| 90648 |
|
12 |
12 |
$0.00 |
| 90670 |
|
14 |
14 |
$0.00 |
| 99173 |
|
13 |
13 |
$0.00 |
| 96127 |
|
342 |
323 |
$0.00 |
| 87807 |
|
37 |
34 |
$0.00 |
| 97802 |
|
12 |
12 |
$0.00 |
| 92551 |
|
15 |
15 |
$0.00 |