| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
639 |
598 |
$41K |
| 90686 |
|
14 |
14 |
$130.68 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
69 |
69 |
$116.16 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
14 |
14 |
$37.65 |
| 99051 |
|
33 |
32 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
14 |
$0.00 |