| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
12 |
12 |
$615.72 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12 |
12 |
$353.32 |
| 90686 |
|
53 |
52 |
$54.83 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
159 |
158 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
376 |
367 |
$0.00 |