| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
39 |
39 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
16 |
16 |
$585.90 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$513.59 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
33 |
33 |
$510.18 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
15 |
$231.90 |
| 96127 |
|
12 |
12 |
$72.24 |
| 99000 |
|
12 |
12 |
$0.00 |