| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
632 |
604 |
$55K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
593 |
551 |
$50K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
418 |
414 |
$40K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
628 |
598 |
$38K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
196 |
190 |
$18K |
| 90686 |
|
406 |
406 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
58 |
56 |
$6K |
| 90670 |
|
280 |
279 |
$4K |
| 90698 |
|
166 |
163 |
$4K |
| 90685 |
|
107 |
105 |
$2K |
| 90633 |
|
62 |
62 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
52 |
26 |
$890.44 |
| 90681 |
|
28 |
27 |
$406.12 |
| 90734 |
|
15 |
15 |
$321.32 |
| 90710 |
|
12 |
12 |
$300.00 |
| 90744 |
|
16 |
14 |
$228.48 |
| 90651 |
|
15 |
14 |
$93.52 |