| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
424 |
280 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
115 |
80 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
218 |
65 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
98 |
60 |
$948.54 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
16 |
13 |
$892.10 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
66 |
15 |
$498.97 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
51 |
43 |
$424.03 |