| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
119 |
119 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
31 |
31 |
$191.10 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
45 |
45 |
$180.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
14 |
14 |
$33.10 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$0.00 |
| 96160 |
|
13 |
13 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12 |
12 |
$0.00 |
| 96127 |
|
14 |
13 |
$0.00 |