| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
371 |
340 |
$16K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
278 |
244 |
$16K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
115 |
96 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
88 |
82 |
$926.86 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
48 |
48 |
$920.53 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
18 |
15 |
$789.74 |
| 90686 |
|
24 |
24 |
$0.00 |