| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
347 |
312 |
$30K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
336 |
320 |
$26K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
233 |
213 |
$12K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
80 |
80 |
$7K |
| 90723 |
|
81 |
80 |
$2K |
| 90686 |
|
190 |
185 |
$1K |
| 90670 |
|
132 |
131 |
$959.75 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
23 |
20 |
$927.36 |
| 90647 |
|
40 |
40 |
$292.50 |
| 90685 |
|
26 |
26 |
$189.28 |