| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,649 |
1,455 |
$146K |
| T1015 |
Clinic visit/encounter, all-inclusive |
212 |
203 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
31 |
31 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
352 |
343 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
111 |
109 |
$644.00 |
| 90670 |
|
40 |
40 |
$312.00 |
| 90647 |
|
34 |
34 |
$256.00 |
| 90686 |
|
17 |
17 |
$158.06 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
491 |
464 |
$122.09 |
| 90680 |
|
14 |
14 |
$112.00 |
| 90723 |
|
14 |
14 |
$112.00 |
| 90633 |
|
14 |
14 |
$104.00 |
| 99307 |
|
197 |
189 |
$0.00 |