| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
219 |
213 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
24 |
24 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
102 |
51 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$975.96 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
19 |
19 |
$276.45 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$143.99 |
| 96160 |
|
39 |
39 |
$138.72 |
| 99174 |
|
13 |
13 |
$71.00 |
| 99000 |
|
13 |
13 |
$0.00 |