| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
150 |
138 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
82 |
75 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
36 |
36 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
31 |
30 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$894.81 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
40 |
19 |
$569.58 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
36 |
35 |
$485.04 |
| 83655 |
|
30 |
29 |
$386.99 |
| 90686 |
|
31 |
31 |
$358.94 |
| 81003 |
|
50 |
50 |
$130.78 |
| 85018 |
|
33 |
32 |
$83.46 |
| 99177 |
|
12 |
12 |
$64.70 |
| 99173 |
|
13 |
13 |
$33.67 |
| 36416 |
|
25 |
25 |
$14.27 |
| 99000 |
|
60 |
56 |
$3.86 |