| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
811 |
779 |
$72K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
921 |
862 |
$45K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
361 |
342 |
$27K |
| 90698 |
|
551 |
538 |
$19K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
209 |
207 |
$18K |
| 90670 |
|
576 |
562 |
$4K |
| 90680 |
|
414 |
408 |
$3K |
| 90744 |
|
270 |
260 |
$2K |
| 90686 |
|
250 |
250 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
18 |
18 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
61 |
44 |
$1K |
| 92587 |
|
36 |
36 |
$1K |
| 99188 |
|
18 |
18 |
$334.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
19 |
19 |
$313.87 |
| 87807 |
|
12 |
12 |
$164.64 |
| 90633 |
|
15 |
15 |
$103.20 |