| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
688 |
644 |
$32K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
234 |
230 |
$14K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
26 |
26 |
$2K |
| 86803 |
|
12 |
12 |
$1K |
| 86780 |
|
26 |
26 |
$1K |
| 87340 |
|
12 |
12 |
$933.17 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$812.40 |
| 81025 |
|
12 |
12 |
$58.87 |