| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
398 |
337 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
342 |
286 |
$8K |
| 90651 |
|
37 |
31 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
219 |
202 |
$6K |
| 92551 |
|
424 |
356 |
$4K |
| 90686 |
|
170 |
159 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
167 |
137 |
$3K |
| 90620 |
|
16 |
14 |
$3K |
| 90734 |
|
23 |
20 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
89 |
72 |
$2K |
| 99177 |
|
430 |
378 |
$1K |
| 90461 |
|
21 |
17 |
$987.50 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15 |
14 |
$825.72 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
31 |
30 |
$608.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
44 |
38 |
$434.72 |
| 83655 |
|
60 |
55 |
$163.90 |
| 96127 |
|
179 |
160 |
$141.50 |
| 96151 |
|
35 |
29 |
$71.50 |
| 99051 |
|
29 |
28 |
$46.30 |
| 96160 |
|
73 |
64 |
$43.92 |
| 85018 |
|
59 |
55 |
$7.34 |
| 80061 |
Lipid panel |
207 |
186 |
$0.09 |
| 85013 |
|
27 |
26 |
$0.08 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
34 |
32 |
$0.02 |