| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
556 |
492 |
$31K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
130 |
130 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
110 |
109 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
50 |
50 |
$4K |
| 90670 |
|
143 |
143 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
113 |
111 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
13 |
$1K |
| 90710 |
|
37 |
37 |
$995.64 |
| 90700 |
|
62 |
62 |
$717.49 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
28 |
28 |
$625.65 |
| 99188 |
|
27 |
26 |
$573.04 |
| 90723 |
|
40 |
40 |
$565.79 |
| 85018 |
|
202 |
199 |
$558.72 |
| 90633 |
|
42 |
41 |
$492.41 |
| 90647 |
|
30 |
30 |
$371.33 |
| 81002 |
|
98 |
96 |
$292.34 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
12 |
12 |
$191.20 |
| 99173 |
|
71 |
69 |
$170.94 |
| 90680 |
|
14 |
14 |
$156.20 |
| 36416 |
|
173 |
170 |
$111.10 |