| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96127 |
|
1,346 |
871 |
$30K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
491 |
441 |
$27K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
634 |
560 |
$22K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
149 |
136 |
$5K |
| 92551 |
|
66 |
54 |
$682.13 |
| 99177 |
|
67 |
58 |
$581.69 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24 |
12 |
$126.11 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$78.72 |
| 90686 |
|
102 |
92 |
$0.00 |
| 3008F |
|
14 |
13 |
$0.00 |