| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,474 |
2,800 |
$279K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
155 |
143 |
$15K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
13 |
13 |
$667.03 |
| 90756 |
|
13 |
13 |
$364.78 |
| 90686 |
|
14 |
14 |
$280.42 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15 |
15 |
$75.00 |
| H0016 |
Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting) |
41 |
38 |
$0.00 |