| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
402 |
360 |
$46K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
60 |
60 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
109 |
109 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
13 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
168 |
165 |
$2K |