| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
139 |
128 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
57 |
57 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
70 |
32 |
$902.10 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
20 |
20 |
$291.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
14 |
12 |
$115.83 |