| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
307 |
302 |
$38K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
339 |
331 |
$29K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
185 |
185 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
71 |
70 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
105 |
103 |
$2K |
| 87070 |
|
54 |
54 |
$477.83 |
| 90686 |
|
69 |
69 |
$68.12 |
| 92551 |
|
12 |
12 |
$6.38 |
| 99173 |
|
12 |
12 |
$0.00 |