| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
624 |
575 |
$36K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
271 |
263 |
$23K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
214 |
214 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
144 |
143 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
28 |
28 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
26 |
26 |
$2K |
| 90686 |
|
106 |
106 |
$1K |
| 90670 |
|
56 |
56 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
61 |
61 |
$833.61 |
| 90698 |
|
52 |
52 |
$822.60 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
42 |
42 |
$582.81 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
14 |
12 |
$496.86 |
| 99173 |
|
149 |
148 |
$375.40 |
| 99188 |
|
12 |
12 |
$261.96 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
32 |
32 |
$255.82 |
| 90680 |
|
12 |
12 |
$124.30 |
| 85018 |
|
18 |
17 |
$50.44 |
| 36416 |
|
103 |
102 |
$49.14 |