| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
289 |
241 |
$15K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
46 |
44 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
65 |
61 |
$786.38 |
| 87081 |
|
59 |
55 |
$408.29 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
42 |
41 |
$241.10 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17 |
17 |
$171.23 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
13 |
$157.47 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
29 |
26 |
$126.80 |
| 85014 |
|
48 |
47 |
$114.63 |
| 85018 |
|
49 |
48 |
$113.01 |
| 81002 |
|
18 |
18 |
$46.64 |
| 90657 |
|
25 |
25 |
$0.00 |