| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
495 |
488 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
233 |
226 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
14 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$693.00 |
| 90686 |
|
112 |
107 |
$546.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$100.66 |
| 96127 |
|
27 |
27 |
$24.70 |
| 3074F |
|
291 |
288 |
$0.00 |
| 1111F |
|
595 |
578 |
$0.00 |
| 3008F |
|
181 |
178 |
$0.00 |
| 90656 |
|
13 |
13 |
$0.00 |
| 96160 |
|
14 |
14 |
$0.00 |
| 3078F |
|
254 |
253 |
$0.00 |