| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
514 |
474 |
$33K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
170 |
167 |
$17K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
71 |
70 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
102 |
50 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$1K |
| 90686 |
|
73 |
73 |
$968.22 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
93 |
91 |
$890.16 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
22 |
21 |
$305.00 |
| 90670 |
|
13 |
13 |
$176.00 |