| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
323 |
305 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
110 |
106 |
$7K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
296 |
145 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
215 |
207 |
$4K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
75 |
74 |
$715.29 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
15 |
15 |
$522.30 |
| 36416 |
|
73 |
71 |
$0.00 |