| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
83 |
75 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
91 |
84 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
92 |
86 |
$4K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
26 |
24 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$1K |
| 90461 |
|
17 |
14 |
$169.40 |
| 99177 |
|
30 |
27 |
$62.64 |
| 94760 |
|
34 |
32 |
$21.60 |
| 99072 |
|
26 |
24 |
$0.00 |