| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
253 |
235 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
156 |
145 |
$12K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
43 |
40 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
60 |
55 |
$764.16 |
| 90686 |
|
52 |
51 |
$624.47 |
| 94760 |
|
131 |
123 |
$257.90 |
| 99000 |
|
58 |
55 |
$177.62 |
| 96160 |
|
112 |
105 |
$175.08 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
116 |
114 |
$142.80 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
13 |
$13.60 |
| 90461 |
|
12 |
12 |
$0.00 |