| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
882 |
799 |
$42K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
347 |
325 |
$26K |
| 92587 |
|
120 |
107 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
24 |
24 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
32 |
24 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 90686 |
|
65 |
65 |
$464.66 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
16 |
$436.61 |
| 90698 |
|
12 |
12 |
$409.85 |
| 90670 |
|
13 |
13 |
$89.07 |