| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
65 |
64 |
$6K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
49 |
47 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
62 |
62 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
20 |
20 |
$570.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
30 |
30 |
$370.50 |
| 90686 |
|
36 |
36 |
$0.00 |