| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
302 |
246 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
656 |
371 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
234 |
205 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
201 |
171 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
615 |
363 |
$9K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,216 |
478 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
131 |
95 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
253 |
147 |
$2K |
| 92551 |
|
276 |
192 |
$1K |
| 87428 |
|
31 |
25 |
$1K |
| 90461 |
|
408 |
301 |
$513.52 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
30 |
15 |
$497.53 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
86 |
27 |
$417.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
26 |
25 |
$288.75 |
| 94760 |
|
166 |
95 |
$0.25 |
| 90670 |
|
132 |
111 |
$0.03 |
| 90734 |
|
33 |
18 |
$0.02 |
| 90633 |
|
30 |
27 |
$0.00 |
| 99173 |
|
158 |
126 |
$0.00 |
| 90697 |
|
45 |
38 |
$0.00 |
| 3008F |
|
17 |
17 |
$0.00 |
| 90698 |
|
46 |
35 |
$0.00 |
| 90680 |
|
48 |
38 |
$0.00 |
| 90651 |
|
42 |
22 |
$0.00 |
| 90688 |
|
143 |
128 |
$0.00 |