| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
529 |
514 |
$32K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
253 |
247 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24 |
12 |
$287.62 |
| 90686 |
|
80 |
74 |
$245.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$150.81 |
| 96127 |
|
24 |
24 |
$24.64 |
| 96160 |
|
24 |
24 |
$21.44 |
| G9920 |
Screening performed and negative |
53 |
53 |
$0.00 |