| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
180 |
152 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
81 |
69 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
34 |
28 |
$2K |
| 87428 |
|
39 |
20 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
27 |
24 |
$1K |
| 71046 |
Radiologic examination, chest; 2 views |
18 |
16 |
$328.05 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
44 |
22 |
$283.14 |
| 90648 |
|
12 |
12 |
$144.54 |
| 90677 |
|
13 |
12 |
$144.54 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
12 |
$88.00 |
| 96127 |
|
24 |
21 |
$81.06 |