| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,532 |
4,830 |
$256K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,927 |
2,889 |
$95K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
786 |
786 |
$62K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
841 |
841 |
$57K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
506 |
506 |
$35K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
155 |
155 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
450 |
350 |
$7K |
| 92551 |
|
900 |
899 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
491 |
466 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
97 |
97 |
$3K |
| 81002 |
|
1,120 |
1,113 |
$2K |
| 90619 |
|
25 |
25 |
$2K |
| 90688 |
|
154 |
154 |
$1K |
| 99174 |
|
42 |
42 |
$433.84 |
| 99173 |
|
280 |
280 |
$423.11 |
| 99051 |
|
36 |
36 |
$304.08 |
| 81000 |
|
28 |
28 |
$68.16 |
| 90686 |
|
15 |
15 |
$12.00 |
| 99001 |
|
26 |
25 |
$0.00 |