| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
464 |
425 |
$24K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
109 |
97 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
15 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
54 |
28 |
$981.22 |
| 90723 |
|
28 |
28 |
$602.84 |
| 90686 |
|
90 |
90 |
$598.26 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
26 |
25 |
$443.26 |
| 90707 |
|
12 |
12 |
$253.82 |
| 90670 |
|
32 |
32 |
$230.46 |
| 90647 |
|
28 |
28 |
$203.71 |
| 90716 |
|
13 |
13 |
$94.05 |
| 90681 |
|
12 |
12 |
$87.63 |
| 87081 |
|
13 |
13 |
$81.71 |