| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
192 |
151 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
69 |
49 |
$2K |
| 87428 |
|
26 |
13 |
$2K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
17 |
16 |
$693.13 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$666.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
79 |
33 |
$614.91 |
| 90461 |
|
41 |
27 |
$220.84 |