| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,113 |
1,008 |
$50K |
| 99215 |
Prolong outpt/office vis |
678 |
631 |
$42K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
109 |
93 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
78 |
78 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
82 |
80 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15 |
12 |
$1K |
| 90686 |
|
76 |
54 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
12 |
$973.28 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
13 |
12 |
$790.46 |
| 90734 |
|
44 |
25 |
$522.75 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
30 |
25 |
$384.08 |
| 90700 |
|
14 |
14 |
$224.60 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
12 |
$203.45 |
| 81003 |
|
31 |
25 |
$67.58 |
| 99072 |
|
16 |
12 |
$0.00 |