| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
168 |
161 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
15 |
15 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
33 |
33 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
14 |
$948.50 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
25 |
25 |
$400.65 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
16 |
16 |
$211.78 |
| 99174 |
|
12 |
12 |
$35.26 |
| 92587 |
|
24 |
23 |
$17.14 |
| 85018 |
|
18 |
18 |
$7.29 |
| 99173 |
|
21 |
20 |
$2.46 |
| 90647 |
|
13 |
13 |
$0.00 |
| 90670 |
|
18 |
18 |
$0.00 |
| 90707 |
|
12 |
12 |
$0.00 |
| 90633 |
|
13 |
13 |
$0.00 |