| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,564 |
3,353 |
$163K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,718 |
1,637 |
$109K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
602 |
602 |
$43K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
380 |
378 |
$25K |
| T1015 |
Clinic visit/encounter, all-inclusive |
251 |
216 |
$20K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
228 |
226 |
$16K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
211 |
203 |
$15K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
728 |
365 |
$10K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
394 |
388 |
$5K |
| 81002 |
|
102 |
96 |
$281.54 |
| 90698 |
|
217 |
217 |
$148.00 |
| 90670 |
|
221 |
221 |
$0.00 |
| 90658 |
|
182 |
182 |
$0.00 |
| 90734 |
|
30 |
30 |
$0.00 |
| 90715 |
|
29 |
29 |
$0.00 |
| 90649 |
|
45 |
45 |
$0.00 |
| 90710 |
|
43 |
43 |
$0.00 |
| 90633 |
|
22 |
22 |
$0.00 |
| 90744 |
|
57 |
57 |
$0.00 |
| 90657 |
|
15 |
15 |
$0.00 |