| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0002A |
|
672 |
672 |
$27K |
| 0001A |
|
721 |
721 |
$26K |
| 0003A |
|
78 |
78 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
133 |
128 |
$3K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
74 |
64 |
$2K |
| 90651 |
|
17 |
17 |
$1K |
| 87535 |
|
39 |
38 |
$912.62 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
59 |
58 |
$904.49 |
| 90710 |
|
14 |
14 |
$897.28 |
| 90734 |
|
18 |
18 |
$806.43 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$624.07 |
| 86780 |
|
40 |
39 |
$588.12 |
| 87661 |
Infectious agent detection by nucleic acid; Trichomonas vaginalis, amplified probe |
13 |
13 |
$394.23 |
| 90716 |
|
14 |
14 |
$364.00 |
| 90715 |
|
26 |
26 |
$310.58 |
| 86702 |
|
39 |
38 |
$292.85 |
| 90723 |
|
12 |
12 |
$278.96 |
| 90707 |
|
14 |
14 |
$274.45 |
| 86701 |
|
39 |
38 |
$195.90 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
45 |
44 |
$190.85 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
104 |
103 |
$155.04 |
| 90633 |
|
15 |
15 |
$122.19 |
| 86593 |
|
40 |
39 |
$120.21 |
| 86592 |
|
42 |
39 |
$101.72 |
| 36415 |
Collection of venous blood by venipuncture |
60 |
59 |
$8.03 |