| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
239 |
213 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
151 |
138 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
258 |
136 |
$3K |
| 92081 |
|
42 |
42 |
$1K |
| 92552 |
|
43 |
43 |
$1K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
18 |
16 |
$821.28 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
20 |
19 |
$579.32 |
| 99000 |
|
30 |
27 |
$205.20 |
| 99080 |
|
12 |
12 |
$0.00 |
| 90686 |
|
71 |
71 |
$0.00 |