| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
997 |
878 |
$49K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
225 |
185 |
$14K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24 |
12 |
$332.64 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
14 |
$194.04 |
| 90688 |
|
16 |
15 |
$166.60 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
30 |
25 |
$146.16 |
| 36415 |
Collection of venous blood by venipuncture |
52 |
44 |
$34.61 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
48 |
29 |
$3.40 |