| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
374 |
354 |
$31K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
200 |
194 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
43 |
43 |
$3K |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$1K |
| 90686 |
|
83 |
81 |
$986.03 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$976.26 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
40 |
36 |
$506.55 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
41 |
16 |
$437.94 |
| 83655 |
|
12 |
12 |
$171.84 |
| 85018 |
|
13 |
13 |
$35.49 |
| 36416 |
|
27 |
27 |
$11.98 |