| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,422 |
1,340 |
$42K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
168 |
133 |
$14K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
443 |
407 |
$11K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
274 |
187 |
$7K |
| 0012A |
|
94 |
94 |
$3K |
| 0013A |
|
33 |
33 |
$2K |
| 0011A |
|
92 |
91 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
132 |
106 |
$2K |
| 99201 |
|
60 |
60 |
$1K |
| 90734 |
|
285 |
266 |
$241.80 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
13 |
$198.35 |
| 90688 |
|
25 |
25 |
$168.94 |
| 90715 |
|
97 |
97 |
$153.99 |
| 90686 |
|
55 |
53 |
$138.09 |
| 81025 |
|
14 |
14 |
$78.80 |
| 90670 |
|
75 |
70 |
$70.00 |
| 90648 |
|
25 |
24 |
$30.00 |
| 90620 |
|
28 |
28 |
$30.00 |
| 90689 |
|
40 |
40 |
$7.00 |
| 91301 |
|
241 |
239 |
$2.09 |
| 91300 |
|
14 |
14 |
$0.13 |
| 90710 |
|
12 |
12 |
$0.01 |
| 90461 |
|
58 |
40 |
$0.00 |
| 90651 |
|
13 |
13 |
$0.00 |