| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99205 |
Prolong outpt/office vis |
225 |
158 |
$24K |
| 99215 |
Prolong outpt/office vis |
258 |
194 |
$22K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
96 |
88 |
$4K |
| 99401 |
|
428 |
238 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
193 |
89 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
23 |
19 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
100 |
91 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$728.00 |
| 90461 |
|
40 |
26 |
$447.20 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
49 |
43 |
$416.00 |
| 99000 |
|
177 |
138 |
$366.80 |
| 85014 |
|
222 |
153 |
$315.00 |
| 81003 |
|
116 |
87 |
$234.00 |
| 36416 |
|
186 |
122 |
$218.00 |
| 36415 |
Collection of venous blood by venipuncture |
129 |
77 |
$102.40 |
| 90671 |
|
13 |
12 |
$96.00 |
| 81002 |
|
62 |
28 |
$69.00 |
| 99173 |
|
26 |
24 |
$20.00 |