| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
895 |
835 |
$47K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
435 |
379 |
$37K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
142 |
140 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
67 |
66 |
$6K |
| 90686 |
|
230 |
224 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$1K |
| 90670 |
|
95 |
94 |
$676.75 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
15 |
14 |
$571.49 |
| 90723 |
|
12 |
12 |
$258.36 |
| 90647 |
|
25 |
25 |
$182.00 |