| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,319 |
1,095 |
$106K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,092 |
942 |
$76K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
32 |
32 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
49 |
45 |
$300.30 |
| 99307 |
|
17 |
16 |
$287.76 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
28 |
12 |
$40.80 |
| 90656 |
|
12 |
12 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
32 |
26 |
$0.00 |
| 81003 |
|
21 |
13 |
$0.00 |