| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
80 |
75 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
58 |
58 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$802.44 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
13 |
$496.80 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
26 |
26 |
$273.80 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
12 |
$205.65 |
| 99051 |
|
312 |
292 |
$191.18 |