| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,076 |
1,053 |
$86K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
765 |
753 |
$38K |
| 99051 |
|
556 |
542 |
$17K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
94 |
93 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$1K |
| 87428 |
|
14 |
14 |
$333.62 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24 |
12 |
$299.76 |
| 99177 |
|
12 |
12 |
$42.00 |
| G9920 |
Screening performed and negative |
14 |
14 |
$0.00 |
| 92551 |
|
27 |
27 |
$0.00 |