| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
105 |
89 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
118 |
104 |
$1K |
| 87428 |
|
86 |
74 |
$573.49 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
12 |
$378.37 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
159 |
131 |
$286.42 |
| 87430 |
|
29 |
24 |
$154.61 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
17 |
14 |
$42.97 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
42 |
34 |
$26.42 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
17 |
13 |
$0.00 |