| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,655 |
2,196 |
$184K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
573 |
537 |
$29K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
57 |
55 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
25 |
25 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$1K |
| 90686 |
|
81 |
60 |
$1K |
| 90674 |
|
21 |
13 |
$597.16 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
17 |
12 |
$516.50 |
| 0012A |
|
12 |
12 |
$510.31 |
| 3078F |
|
423 |
386 |
$0.00 |
| 3725F |
|
131 |
115 |
$0.00 |
| 1160F |
|
654 |
600 |
$0.00 |
| 1159F |
|
500 |
454 |
$0.00 |
| 3008F |
|
578 |
529 |
$0.00 |
| 3074F |
|
372 |
337 |
$0.00 |
| 1036F |
|
435 |
395 |
$0.00 |