| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,424 |
2,776 |
$245K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,694 |
1,574 |
$38K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
89 |
89 |
$8K |
| 92551 |
|
435 |
435 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
51 |
51 |
$4K |
| 99401 |
|
94 |
89 |
$3K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
109 |
100 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
150 |
140 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
138 |
67 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$873.16 |
| 99173 |
|
255 |
255 |
$695.06 |
| 96160 |
|
24 |
24 |
$56.74 |
| 90686 |
|
14 |
14 |
$22.03 |
| 99000 |
|
112 |
105 |
$0.00 |