| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
226 |
223 |
$190.89 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
434 |
225 |
$152.80 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
255 |
246 |
$150.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
264 |
264 |
$57.24 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
211 |
209 |
$56.19 |
| 92552 |
|
362 |
361 |
$46.50 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,466 |
1,418 |
$36.07 |
| 85018 |
|
141 |
141 |
$2.82 |
| 36416 |
|
150 |
150 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
72 |
71 |
$0.00 |
| 96127 |
|
110 |
110 |
$0.00 |
| 90716 |
|
14 |
14 |
$0.00 |
| 92551 |
|
12 |
12 |
$0.00 |
| 99177 |
|
345 |
344 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
159 |
159 |
$0.00 |
| 90461 |
|
84 |
84 |
$0.00 |
| 99173 |
|
12 |
12 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
96 |
96 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
74 |
74 |
$0.00 |
| 81003 |
|
14 |
14 |
$0.00 |
| 99188 |
|
14 |
14 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
20 |
20 |
$0.00 |