| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
159 |
151 |
$15K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
94 |
94 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
54 |
39 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
15 |
14 |
$1K |
| 96127 |
|
19 |
19 |
$294.69 |