| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
872 |
750 |
$32K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
43 |
40 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17 |
14 |
$951.45 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
17 |
12 |
$868.69 |
| 90686 |
|
150 |
143 |
$783.70 |
| 88738 |
|
158 |
133 |
$657.88 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
32 |
15 |
$501.44 |