| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
317 |
285 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
60 |
52 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
43 |
42 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
34 |
27 |
$469.50 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$188.40 |
| 90685 |
|
28 |
28 |
$179.20 |
| 90670 |
|
12 |
12 |
$76.80 |