| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
478 |
417 |
$27K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
51 |
44 |
$4K |
| 90686 |
|
83 |
82 |
$912.18 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
12 |
$360.36 |
| 92551 |
|
43 |
38 |
$356.67 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
103 |
91 |
$118.50 |
| 99173 |
|
14 |
14 |
$34.58 |
| 99000 |
|
17 |
14 |
$29.44 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
38 |
38 |
$23.80 |
| 99072 |
|
93 |
52 |
$0.00 |