| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
380 |
370 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
114 |
113 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
157 |
151 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
70 |
69 |
$7K |
| 99051 |
|
79 |
78 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 99188 |
|
29 |
29 |
$582.60 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
69 |
68 |
$541.59 |
| 92551 |
|
166 |
165 |
$508.42 |
| 99173 |
|
135 |
135 |
$388.00 |
| 99177 |
|
26 |
26 |
$235.80 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
28 |
27 |
$38.50 |
| 96127 |
|
33 |
32 |
$15.40 |
| 96160 |
|
45 |
45 |
$13.41 |
| 90688 |
|
68 |
68 |
$0.00 |