| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
765 |
737 |
$42K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
59 |
59 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
24 |
24 |
$2K |
| 99050 |
|
154 |
152 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$887.50 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
30 |
30 |
$431.67 |
| 90670 |
|
12 |
12 |
$136.40 |
| 90648 |
|
12 |
12 |
$136.40 |