| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
341 |
286 |
$17K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
323 |
259 |
$12K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
138 |
67 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
91 |
87 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
18 |
12 |
$141.12 |