| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
123 |
117 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
38 |
33 |
$2K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
31 |
26 |
$963.92 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
31 |
26 |
$934.70 |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
13 |
13 |
$803.30 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
21 |
17 |
$563.40 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
12 |
$188.40 |
| 81025 |
|
15 |
13 |
$36.12 |