| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
253 |
240 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
65 |
62 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
69 |
69 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
25 |
25 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
90 |
45 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
61 |
61 |
$886.60 |
| 90670 |
|
15 |
15 |
$165.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
13 |
13 |
$135.52 |
| 96161 |
|
12 |
12 |
$44.88 |
| 99000 |
|
79 |
77 |
$0.00 |