| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
611 |
593 |
$29K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
271 |
261 |
$18K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
13 |
$274.78 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$163.26 |
| 96127 |
|
15 |
15 |
$30.80 |
| 96160 |
|
16 |
16 |
$26.80 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
31 |
31 |
$21.56 |
| G9920 |
Screening performed and negative |
35 |
35 |
$0.00 |
| 90661 |
|
18 |
18 |
$0.00 |
| 92551 |
|
34 |
34 |
$0.00 |
| 90686 |
|
15 |
15 |
$0.00 |