| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
90 |
87 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
16 |
16 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
27 |
27 |
$402.50 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
60 |
30 |
$381.12 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
18 |
18 |
$272.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
22 |
22 |
$142.79 |
| 96160 |
|
32 |
32 |
$75.00 |