| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
609 |
516 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
230 |
200 |
$13K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
14 |
14 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
131 |
111 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
44 |
37 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
153 |
134 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
32 |
29 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$507.69 |
| 90686 |
|
29 |
26 |
$358.06 |
| 87807 |
|
25 |
18 |
$182.14 |
| 90670 |
|
13 |
12 |
$105.16 |
| T1502 |
Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit |
21 |
17 |
$27.20 |