| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,543 |
1,828 |
$148K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,283 |
1,641 |
$105K |
| 99199 |
Unlisted special service, procedure or report |
6,480 |
4,722 |
$25K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
78 |
56 |
$2K |
| 36415 |
Collection of venous blood by venipuncture |
1,363 |
1,009 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
16 |
12 |
$531.70 |
| 90674 |
|
45 |
37 |
$429.76 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
16 |
14 |
$365.44 |
| 90686 |
|
65 |
38 |
$256.51 |
| 90656 |
|
12 |
12 |
$107.35 |
| G0008 |
Administration of influenza virus vaccine |
27 |
26 |
$0.00 |
| 3074F |
|
45 |
39 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
16 |
14 |
$0.00 |
| 90756 |
|
14 |
13 |
$0.00 |
| 3078F |
|
47 |
41 |
$0.00 |