| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
131 |
130 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
58 |
57 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
111 |
104 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
361 |
347 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
33 |
30 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
23 |
23 |
$345.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
33 |
33 |
$247.50 |
| 96160 |
|
21 |
21 |
$58.76 |
| 99173 |
|
61 |
54 |
$55.51 |
| 96127 |
|
17 |
13 |
$32.89 |
| 99177 |
|
13 |
13 |
$30.68 |
| 90686 |
|
52 |
49 |
$19.95 |
| 99401 |
|
119 |
113 |
$0.00 |