| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
188 |
176 |
$13K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
119 |
112 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$1K |
| 90461 |
|
33 |
33 |
$832.26 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
49 |
49 |
$617.89 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
13 |
13 |
$332.10 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
33 |
33 |
$234.63 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
29 |
29 |
$174.98 |
| 81003 |
|
16 |
16 |
$29.10 |
| 94760 |
|
46 |
39 |
$0.00 |
| 90670 |
|
12 |
12 |
$0.00 |