| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,088 |
937 |
$63K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
269 |
252 |
$19K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
349 |
335 |
$6K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
151 |
147 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
28 |
13 |
$392.00 |
| 90686 |
|
135 |
123 |
$66.50 |
| 99177 |
|
12 |
12 |
$37.20 |