| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
108 |
105 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
64 |
57 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
44 |
44 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
40 |
40 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
32 |
32 |
$3K |
| 90670 |
|
28 |
28 |
$621.10 |
| 90688 |
|
40 |
40 |
$473.30 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
12 |
$378.30 |
| 81003 |
|
52 |
51 |
$141.96 |
| 99174 |
|
13 |
13 |
$92.30 |
| 99173 |
|
35 |
35 |
$90.65 |