| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,501 |
1,373 |
$69K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
284 |
258 |
$26K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
442 |
430 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
27 |
27 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
164 |
156 |
$615.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
173 |
173 |
$533.93 |
| 90686 |
|
30 |
30 |
$59.09 |