| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
764 |
731 |
$48K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,558 |
1,453 |
$38K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
176 |
168 |
$15K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,069 |
1,063 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
15 |
15 |
$349.70 |
| 90461 |
|
14 |
12 |
$340.80 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
26 |
25 |
$317.46 |
| 90686 |
|
416 |
416 |
$19.58 |
| 99177 |
|
15 |
15 |
$18.00 |
| 99072 |
|
13 |
13 |
$0.00 |
| 96127 |
|
19 |
19 |
$0.00 |