| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
79 |
70 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
18 |
18 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
41 |
41 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16 |
16 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
13 |
$1K |
| 92567 |
|
35 |
31 |
$449.75 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
29 |
29 |
$216.42 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
14 |
$85.28 |
| 90700 |
|
15 |
15 |
$0.00 |
| 90713 |
|
15 |
15 |
$0.00 |