| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,842 |
1,640 |
$65K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
123 |
115 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
444 |
173 |
$4K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
92 |
90 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
226 |
108 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
25 |
25 |
$2K |
| 90461 |
|
76 |
65 |
$669.21 |
| 97169 |
|
12 |
12 |
$410.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
29 |
27 |
$363.92 |
| 87807 |
|
25 |
25 |
$254.68 |
| 92552 |
|
50 |
50 |
$0.00 |