| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,755 |
1,592 |
$56K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
947 |
866 |
$53K |
| 87428 |
|
77 |
74 |
$5K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
14 |
14 |
$633.22 |
| 90686 |
|
40 |
37 |
$353.72 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
13 |
$167.31 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
14 |
12 |
$101.00 |
| 3074F |
|
25 |
25 |
$0.00 |
| 3078F |
|
27 |
25 |
$0.00 |