| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
426 |
391 |
$21K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
35 |
34 |
$2K |
| 99443 |
|
65 |
48 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
80 |
78 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
68 |
66 |
$595.66 |
| 86328 |
|
12 |
12 |
$542.76 |
| 99173 |
|
12 |
12 |
$270.12 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
14 |
14 |
$40.90 |
| 90686 |
|
91 |
90 |
$19.04 |
| 99000 |
|
84 |
80 |
$0.00 |