| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
463 |
406 |
$24K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
756 |
632 |
$24K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
109 |
109 |
$2K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
32 |
27 |
$1K |
| 92587 |
|
25 |
25 |
$804.34 |
| 99051 |
|
59 |
54 |
$343.20 |
| 85018 |
|
83 |
83 |
$225.65 |
| 90686 |
|
35 |
35 |
$0.00 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
18 |
12 |
$0.00 |
| 99080 |
|
136 |
72 |
$0.00 |