| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,522 |
2,266 |
$77K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,566 |
1,442 |
$40K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
110 |
104 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
83 |
79 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
26 |
26 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
25 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
70 |
32 |
$796.80 |
| 36415 |
Collection of venous blood by venipuncture |
26 |
24 |
$36.00 |