| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,036 |
6,911 |
$767K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,301 |
3,724 |
$362K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
134 |
134 |
$19K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
55 |
50 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
47 |
47 |
$6K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
141 |
136 |
$11.26 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
61 |
61 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
28 |
27 |
$0.00 |