| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,355 |
1,206 |
$47K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
828 |
358 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
50 |
49 |
$4K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
65 |
59 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
27 |
26 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$913.33 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
62 |
31 |
$847.90 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
60 |
59 |
$805.62 |
| 90461 |
|
50 |
43 |
$328.79 |
| 87428 |
|
15 |
14 |
$146.98 |
| 90686 |
|
28 |
28 |
$38.75 |
| 90648 |
|
13 |
13 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |