| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,535 |
1,364 |
$65K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
949 |
882 |
$53K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
220 |
220 |
$27K |
| 99080 |
|
885 |
838 |
$24K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
206 |
206 |
$19K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
46 |
46 |
$4K |
| 90688 |
|
290 |
290 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$1K |
| 90686 |
|
85 |
85 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
138 |
118 |
$895.29 |
| 99499 |
|
41 |
36 |
$881.00 |
| 96160 |
|
163 |
161 |
$539.27 |
| 90700 |
|
40 |
40 |
$538.84 |
| 96127 |
|
72 |
72 |
$378.00 |
| 3008F |
|
28 |
28 |
$280.00 |
| 90713 |
|
14 |
14 |
$198.52 |
| 90647 |
|
13 |
13 |
$184.34 |
| 99051 |
|
25 |
24 |
$0.00 |
| 83655 |
|
12 |
12 |
$0.00 |
| 99000 |
|
210 |
200 |
$0.00 |