| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,417 |
1,217 |
$52K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
465 |
412 |
$25K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$748.08 |
| 92552 |
|
25 |
25 |
$318.03 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24 |
12 |
$317.76 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$158.64 |
| 90658 |
|
14 |
13 |
$60.00 |