| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
840 |
764 |
$41K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
402 |
381 |
$30K |
| 92587 |
|
162 |
159 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
27 |
26 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
87 |
45 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$989.70 |
| 90686 |
|
133 |
133 |
$945.28 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
50 |
50 |
$782.79 |
| 90685 |
|
12 |
12 |
$84.46 |