| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
617 |
455 |
$26K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
393 |
274 |
$13K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
175 |
155 |
$2K |
| 92583 |
|
111 |
105 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
12 |
$819.24 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
99 |
46 |
$622.80 |
| 87428 |
|
28 |
20 |
$469.26 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
19 |
19 |
$180.87 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
61 |
31 |
$55.44 |
| 36416 |
|
14 |
14 |
$0.00 |