| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
365 |
281 |
$28K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
288 |
232 |
$17K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
373 |
286 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
29 |
24 |
$2K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
70 |
65 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
150 |
67 |
$1K |
| 87428 |
|
32 |
30 |
$936.64 |
| 96160 |
|
55 |
50 |
$50.25 |
| 3008F |
|
77 |
72 |
$0.00 |
| 90686 |
|
27 |
27 |
$0.00 |
| 36416 |
|
18 |
14 |
$0.00 |