| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
613 |
570 |
$69K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
298 |
291 |
$22K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
677 |
674 |
$9K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
135 |
132 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
25 |
25 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
15 |
$2K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
41 |
40 |
$854.13 |
| 92551 |
|
92 |
91 |
$508.44 |
| 99173 |
|
51 |
51 |
$8.22 |
| 99000 |
|
157 |
150 |
$0.00 |
| 90686 |
|
164 |
164 |
$0.00 |