| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
300 |
245 |
$25K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
86 |
78 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
39 |
36 |
$933.24 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16 |
15 |
$888.20 |
| 90686 |
|
27 |
27 |
$494.78 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
22 |
22 |
$278.04 |
| 94760 |
|
111 |
89 |
$38.72 |
| 87999 |
|
22 |
22 |
$0.00 |
| 99051 |
|
105 |
99 |
$0.00 |
| 99000 |
|
26 |
26 |
$0.00 |