| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
495 |
441 |
$26K |
| 99401 |
|
436 |
397 |
$10K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
372 |
369 |
$8K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
92 |
92 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$585.16 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$532.28 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$514.11 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
21 |
18 |
$262.12 |
| 90461 |
|
12 |
12 |
$225.00 |
| 90686 |
|
38 |
38 |
$102.82 |