| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,204 |
2,099 |
$106K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
97 |
97 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
292 |
286 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
180 |
99 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
26 |
25 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
13 |
$962.74 |
| 87081 |
|
102 |
102 |
$897.68 |
| 90686 |
|
18 |
18 |
$121.70 |
| 90670 |
|
12 |
12 |
$80.51 |