| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
307 |
291 |
$18K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
43 |
41 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
27 |
27 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$993.20 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
32 |
32 |
$900.98 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
52 |
50 |
$756.60 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
55 |
49 |
$125.58 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
12 |
12 |
$101.64 |
| 90461 |
|
19 |
14 |
$46.20 |