| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,732 |
1,590 |
$113K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,279 |
1,208 |
$103K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
16 |
16 |
$568.54 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
13 |
13 |
$547.83 |
| 99072 |
|
124 |
122 |
$64.63 |
| 96160 |
|
130 |
130 |
$0.36 |