| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
304 |
296 |
$26K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
315 |
304 |
$19K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
267 |
258 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
61 |
61 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
49 |
49 |
$4K |
| 99173 |
|
139 |
139 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
237 |
237 |
$3K |
| 90461 |
|
12 |
12 |
$523.42 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
40 |
40 |
$519.60 |
| 80061 |
Lipid panel |
26 |
26 |
$394.94 |
| 83655 |
|
16 |
16 |
$219.84 |
| 85018 |
|
13 |
13 |
$34.84 |
| 90686 |
|
123 |
123 |
$30.76 |