| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
128 |
124 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
148 |
144 |
$4K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
67 |
65 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$536.50 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
33 |
33 |
$500.94 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$496.60 |
| 90461 |
|
15 |
15 |
$273.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
191 |
188 |
$255.00 |
| S9451 |
Exercise classes, non-physician provider, per session |
112 |
112 |
$72.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
217 |
214 |
$63.00 |
| 90686 |
|
28 |
25 |
$60.09 |
| 92551 |
|
113 |
113 |
$20.58 |
| 96127 |
|
111 |
109 |
$5.14 |
| 96160 |
|
12 |
12 |
$2.61 |
| 3008F |
|
113 |
112 |
$0.00 |
| 99000 |
|
128 |
126 |
$0.00 |
| 97802 |
|
279 |
275 |
$0.00 |