| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
813 |
735 |
$59K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
998 |
875 |
$47K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
133 |
127 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
120 |
113 |
$10K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
50 |
45 |
$1K |
| 90686 |
|
80 |
80 |
$635.72 |
| 90656 |
|
15 |
15 |
$305.67 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
12 |
$204.10 |