| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
517 |
453 |
$36K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
709 |
675 |
$12K |
| 92552 |
|
135 |
125 |
$2K |
| 90656 |
|
75 |
70 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
25 |
24 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
26 |
22 |
$832.00 |
| 90480 |
|
13 |
13 |
$492.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
14 |
14 |
$244.02 |
| 99173 |
|
114 |
109 |
$213.38 |
| 90686 |
|
133 |
121 |
$143.97 |
| 96127 |
|
12 |
12 |
$32.16 |
| 99000 |
|
168 |
136 |
$0.00 |