| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,301 |
1,117 |
$64K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
100 |
90 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
151 |
121 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
15 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
36 |
30 |
$915.12 |
| 90674 |
|
30 |
27 |
$508.44 |
| 90686 |
|
59 |
57 |
$377.60 |
| 90688 |
|
12 |
12 |
$203.86 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
27 |
14 |
$0.00 |