| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
460 |
436 |
$27K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
296 |
274 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
305 |
298 |
$6K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
476 |
461 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$142.55 |
| 90686 |
|
55 |
54 |
$19.58 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$0.00 |