| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
637 |
619 |
$47K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
198 |
198 |
$2K |
| 99177 |
|
74 |
74 |
$820.76 |
| 90686 |
|
68 |
68 |
$264.85 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
110 |
109 |
$194.40 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
16 |
12 |
$148.06 |
| 99051 |
|
34 |
34 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$0.00 |