| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
274 |
257 |
$24K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
346 |
319 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
151 |
140 |
$13K |
| 90698 |
|
163 |
163 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
58 |
58 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
35 |
27 |
$2K |
| 90686 |
|
172 |
172 |
$1K |
| 90670 |
|
164 |
164 |
$1K |
| 90681 |
|
64 |
64 |
$452.54 |
| 90744 |
|
32 |
32 |
$227.54 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$203.99 |
| 90680 |
|
13 |
13 |
$92.98 |