| Code | Description | Claims | Beneficiaries | Total Paid |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,163 |
2,672 |
$130K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
878 |
781 |
$28K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
228 |
178 |
$7K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
86 |
67 |
$2K |
| 87428 |
|
17 |
17 |
$826.67 |
| 99215 |
Prolong outpt/office vis |
17 |
12 |
$464.48 |
| 90674 |
|
12 |
12 |
$308.37 |
| 90688 |
|
16 |
16 |
$223.48 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
21 |
21 |
$207.83 |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
280 |
256 |
$0.00 |