| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
896 |
782 |
$33K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
191 |
178 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
119 |
110 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
169 |
164 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
92 |
45 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17 |
16 |
$800.00 |
| 90461 |
|
45 |
42 |
$595.00 |
| 92558 |
|
172 |
169 |
$517.70 |
| 90686 |
|
35 |
35 |
$240.36 |
| 99000 |
|
189 |
180 |
$0.00 |
| 99173 |
|
91 |
89 |
$0.00 |