| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
817 |
736 |
$30K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
148 |
144 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
97 |
96 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
95 |
47 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
63 |
62 |
$805.20 |
| 92558 |
|
85 |
81 |
$241.80 |
| 90461 |
|
14 |
14 |
$210.00 |
| 90686 |
|
26 |
26 |
$160.24 |
| 99173 |
|
39 |
34 |
$0.00 |
| 99000 |
|
115 |
114 |
$0.00 |