| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
115 |
102 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
145 |
125 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
70 |
70 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
35 |
32 |
$386.94 |
| 90461 |
|
12 |
12 |
$318.04 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
28 |
14 |
$264.80 |