| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
750 |
703 |
$41K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
41 |
40 |
$3K |
| 99050 |
|
174 |
173 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
24 |
24 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
118 |
117 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15 |
15 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
48 |
48 |
$675.69 |
| 90686 |
|
26 |
26 |
$321.72 |
| 90670 |
|
12 |
12 |
$135.85 |