| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,196 |
930 |
$57K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
89 |
72 |
$7K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
15 |
15 |
$549.02 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
29 |
15 |
$451.29 |
| 90670 |
|
12 |
12 |
$410.30 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
32 |
15 |
$288.44 |
| 90688 |
|
26 |
12 |
$180.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
26 |
26 |
$0.00 |