| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,065 |
929 |
$60K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
332 |
297 |
$27K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
90 |
90 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
58 |
57 |
$5K |
| 90698 |
|
115 |
115 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
25 |
25 |
$2K |
| 90686 |
|
136 |
135 |
$2K |
| 90670 |
|
129 |
129 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
33 |
27 |
$938.24 |
| 90680 |
|
27 |
27 |
$310.82 |
| 90710 |
|
12 |
12 |
$294.57 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$189.61 |