| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
664 |
600 |
$47K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
13 |
$625.80 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
63 |
49 |
$461.93 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
66 |
64 |
$450.76 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17 |
13 |
$170.17 |
| 99177 |
|
28 |
26 |
$119.00 |
| 85018 |
|
59 |
55 |
$74.48 |
| 81003 |
|
14 |
13 |
$17.64 |
| 92558 |
|
28 |
26 |
$10.31 |