| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
110 |
106 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
32 |
32 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
30 |
15 |
$309.90 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
25 |
25 |
$252.25 |
| 99051 |
|
19 |
19 |
$182.40 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
16 |
16 |
$164.96 |
| 87081 |
|
16 |
16 |
$73.44 |
| 94760 |
|
36 |
34 |
$0.00 |
| G9153 |
Mapcp demonstration - physician incentive pool |
12 |
12 |
$0.00 |