| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
567 |
551 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
150 |
141 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
15 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$891.00 |
| 90686 |
|
57 |
54 |
$566.96 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
12 |
12 |
$270.20 |
| 99173 |
|
33 |
33 |
$67.21 |
| 92551 |
|
15 |
15 |
$48.83 |
| 1111F |
|
761 |
727 |
$0.00 |
| 3074F |
|
12 |
12 |
$0.00 |
| 3078F |
|
12 |
12 |
$0.00 |