| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,789 |
1,648 |
$75K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
931 |
645 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
403 |
396 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
66 |
64 |
$5K |
| 92587 |
|
442 |
284 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
159 |
153 |
$2K |
| 90686 |
|
165 |
126 |
$844.26 |
| 96127 |
|
31 |
30 |
$113.93 |
| 99174 |
|
53 |
53 |
$20.22 |
| 3008F |
|
198 |
198 |
$0.00 |
| 99000 |
|
13 |
13 |
$0.00 |
| 90700 |
|
40 |
24 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
16 |
16 |
$0.00 |
| 99072 |
|
13 |
13 |
$0.00 |
| 99177 |
|
19 |
16 |
$0.00 |
| 90713 |
|
21 |
13 |
$0.00 |