| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,244 |
1,007 |
$54K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
65 |
30 |
$985.95 |
| 90686 |
|
107 |
105 |
$742.82 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
13 |
13 |
$459.29 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17 |
14 |
$273.19 |
| 90685 |
|
16 |
14 |
$102.40 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
61 |
56 |
$0.00 |