| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
667 |
603 |
$30K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
447 |
408 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
42 |
42 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
27 |
18 |
$608.70 |
| 90686 |
|
72 |
60 |
$587.61 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
31 |
30 |
$471.79 |
| 94762 |
|
18 |
18 |
$0.00 |
| 3074F |
|
16 |
14 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
228 |
205 |
$0.00 |
| 1160F |
|
431 |
406 |
$0.00 |
| 1159F |
|
431 |
406 |
$0.00 |
| 4124F |
|
13 |
13 |
$0.00 |
| 90461 |
|
15 |
12 |
$0.00 |
| 4120F |
|
98 |
96 |
$0.00 |
| 3078F |
|
17 |
15 |
$0.00 |
| 4274F |
|
13 |
13 |
$0.00 |