| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
142 |
133 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
94 |
89 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
27 |
27 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
40 |
15 |
$685.54 |
| 90698 |
|
12 |
12 |
$360.73 |
| 90686 |
|
48 |
48 |
$328.06 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
14 |
$248.37 |
| 90670 |
|
13 |
13 |
$82.58 |