| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
257 |
226 |
$8K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
14 |
13 |
$558.61 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
298 |
112 |
$528.95 |
| 90461 |
|
83 |
62 |
$320.30 |
| 99000 |
|
14 |
12 |
$40.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
34 |
27 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$0.00 |
| 96127 |
|
12 |
12 |
$0.00 |