| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
84 |
68 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
16 |
13 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
22 |
21 |
$203.94 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
87 |
64 |
$165.22 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
66 |
22 |
$120.32 |
| 96160 |
|
12 |
12 |
$42.84 |
| 87807 |
|
22 |
15 |
$40.38 |