| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,066 |
2,647 |
$208K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
214 |
185 |
$20K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
12 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$1K |
| 90686 |
|
49 |
48 |
$996.96 |
| 90688 |
|
28 |
28 |
$521.46 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
30 |
14 |
$324.52 |