| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
573 |
549 |
$32K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
210 |
206 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
96 |
96 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
57 |
57 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
57 |
57 |
$4K |
| 99058 |
|
244 |
236 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
12 |
$368.36 |
| 90698 |
|
13 |
12 |
$315.09 |
| 90670 |
|
44 |
43 |
$219.10 |
| 90688 |
|
33 |
33 |
$173.42 |
| 90686 |
|
29 |
29 |
$155.15 |
| 90648 |
|
12 |
12 |
$64.20 |