| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
819 |
665 |
$32K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
283 |
275 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
465 |
457 |
$3K |
| 92567 |
|
176 |
174 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
15 |
$758.85 |
| 92587 |
|
36 |
36 |
$509.12 |
| 81002 |
|
218 |
215 |
$458.39 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
19 |
17 |
$139.42 |
| 99173 |
|
54 |
53 |
$115.10 |
| 81000 |
|
13 |
13 |
$46.69 |