| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
603 |
512 |
$29K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
58 |
54 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
132 |
129 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$1K |
| 99401 |
|
244 |
242 |
$914.85 |
| 92587 |
|
57 |
56 |
$657.30 |
| 96127 |
|
88 |
88 |
$256.53 |
| 99188 |
|
12 |
12 |
$250.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$92.60 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
14 |
14 |
$80.38 |
| 96160 |
|
14 |
14 |
$18.10 |