| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
374 |
353 |
$29K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
311 |
298 |
$27K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
272 |
272 |
$12K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
39 |
37 |
$4K |
| 96161 |
|
368 |
323 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
26 |
25 |
$233.22 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$175.39 |
| 96127 |
|
21 |
20 |
$82.11 |
| 90656 |
|
29 |
29 |
$3.00 |
| 90697 |
|
53 |
53 |
$0.00 |
| 90686 |
|
57 |
57 |
$0.00 |
| 90677 |
|
16 |
16 |
$0.00 |
| 90680 |
|
40 |
40 |
$0.00 |
| 90670 |
|
28 |
28 |
$0.00 |
| 96160 |
|
79 |
79 |
$0.00 |
| 90671 |
|
26 |
26 |
$0.00 |