| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
59 |
54 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
28 |
28 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
40 |
40 |
$680.53 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
17 |
15 |
$544.32 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
33 |
33 |
$0.00 |
| 90698 |
|
13 |
13 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
12 |
12 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
20 |
19 |
$0.00 |
| 90461 |
|
15 |
15 |
$0.00 |