| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
468 |
449 |
$21K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
13 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$917.26 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$887.50 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
15 |
12 |
$327.83 |
| 90686 |
|
34 |
34 |
$208.55 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$167.74 |
| 87070 |
|
16 |
16 |
$134.76 |
| 90670 |
|
12 |
12 |
$73.13 |