| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90686 |
|
92 |
41 |
$15.45 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,494 |
778 |
$0.00 |
| 90716 |
|
17 |
14 |
$0.00 |
| 87807 |
|
13 |
13 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
411 |
269 |
$0.00 |
| 90677 |
|
19 |
17 |
$0.00 |
| 90648 |
|
17 |
13 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
39 |
30 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
70 |
49 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
102 |
46 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
93 |
79 |
$0.00 |
| 90661 |
|
31 |
27 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
65 |
48 |
$0.00 |