| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
389 |
319 |
$13K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
56 |
45 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
35 |
26 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
180 |
85 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
18 |
14 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
98 |
89 |
$640.10 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
29 |
22 |
$255.14 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
26 |
14 |
$129.92 |
| 81025 |
|
31 |
24 |
$54.89 |
| 81003 |
|
57 |
47 |
$53.85 |
| 90461 |
|
23 |
12 |
$0.00 |