| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
673 |
592 |
$159K |
| 3074F |
|
152 |
149 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
290 |
254 |
$0.00 |
| 92551 |
|
61 |
61 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
41 |
39 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
31 |
31 |
$0.00 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
12 |
12 |
$0.00 |
| 99173 |
|
63 |
63 |
$0.00 |
| 1159F |
|
282 |
270 |
$0.00 |
| 3078F |
|
145 |
142 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
30 |
30 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
14 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$0.00 |