| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,073 |
4,902 |
$239K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,397 |
1,629 |
$96K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
240 |
191 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
241 |
182 |
$11K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
142 |
131 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
26 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
75 |
69 |
$901.36 |
| 90686 |
|
87 |
82 |
$880.72 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
260 |
184 |
$726.33 |
| 90651 |
|
14 |
12 |
$514.22 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17 |
12 |
$446.32 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
54 |
35 |
$368.80 |
| 90674 |
|
25 |
24 |
$144.00 |
| 90630 |
|
224 |
131 |
$0.00 |
| 3008F |
|
12 |
12 |
$0.00 |