| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
743 |
317 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
112 |
101 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
41 |
41 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
390 |
312 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
18 |
18 |
$1K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
13 |
13 |
$587.15 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15 |
15 |
$533.36 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
13 |
$394.51 |
| 90461 |
|
59 |
54 |
$376.60 |
| S8301 |
Infection control supplies, not otherwise specified |
13 |
13 |
$287.00 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
13 |
13 |
$192.15 |
| 96160 |
|
15 |
15 |
$2.25 |
| 96127 |
|
34 |
25 |
$0.00 |
| 90686 |
|
38 |
37 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |