| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
255 |
241 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
203 |
171 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
324 |
315 |
$872.75 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
420 |
372 |
$643.37 |
| 0071A |
|
13 |
13 |
$567.84 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
66 |
66 |
$125.43 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
256 |
239 |
$115.76 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
29 |
27 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$0.00 |
| 86580 |
|
15 |
13 |
$0.00 |
| 96127 |
|
133 |
125 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
125 |
119 |
$0.00 |
| 91307 |
|
13 |
13 |
$0.00 |