| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
675 |
503 |
$37K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
110 |
96 |
$8K |
| 99381 |
|
42 |
42 |
$4K |
| 99401 |
|
202 |
140 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
67 |
65 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$845.10 |
| 96161 |
|
164 |
110 |
$279.50 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$160.90 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
15 |
$10.27 |