| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
240 |
223 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
164 |
152 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
246 |
233 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
81 |
81 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
40 |
37 |
$1K |
| 90686 |
|
72 |
72 |
$476.78 |
| 90723 |
|
14 |
14 |
$461.16 |
| 90670 |
|
40 |
40 |
$266.00 |
| 90647 |
|
13 |
13 |
$85.67 |
| 90685 |
|
12 |
12 |
$79.08 |