| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
406 |
379 |
$36K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
30 |
28 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
59 |
58 |
$622.24 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
25 |
25 |
$392.00 |
| 96127 |
|
105 |
77 |
$237.35 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
12 |
$81.60 |
| 90686 |
|
38 |
38 |
$19.00 |