| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
56 |
54 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
29 |
28 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
15 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
13 |
13 |
$459.29 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
33 |
32 |
$229.28 |
| 96160 |
|
101 |
44 |
$121.76 |
| 81002 |
|
51 |
42 |
$77.00 |
| 99173 |
|
16 |
13 |
$34.56 |
| 99072 |
|
14 |
14 |
$0.00 |
| 3008F |
|
58 |
46 |
$0.00 |
| 99000 |
|
34 |
33 |
$0.00 |