| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,037 |
1,727 |
$156K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
619 |
587 |
$17K |
| 92551 |
|
256 |
238 |
$5K |
| 90686 |
|
212 |
207 |
$4K |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
19 |
17 |
$4K |
| 87428 |
|
49 |
31 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
498 |
478 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$756.00 |
| 90658 |
|
43 |
42 |
$737.39 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
35 |
34 |
$711.68 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
19 |
14 |
$589.38 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
15 |
15 |
$350.00 |
| 90461 |
|
14 |
13 |
$345.00 |
| 96127 |
|
39 |
26 |
$162.98 |