| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,282 |
4,529 |
$303K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,655 |
2,400 |
$200K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
144 |
136 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
45 |
45 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
26 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
28 |
25 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
44 |
19 |
$928.25 |