| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
123 |
122 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
14 |
14 |
$795.92 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
40 |
20 |
$553.20 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$179.79 |
| 36415 |
Collection of venous blood by venipuncture |
12 |
12 |
$26.88 |