| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
58 |
56 |
$831.06 |
| 96127 |
|
35 |
35 |
$359.45 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
506 |
481 |
$321.15 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
31 |
27 |
$318.37 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
148 |
146 |
$43.74 |
| 85018 |
|
13 |
13 |
$27.17 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27 |
26 |
$0.00 |
| 90461 |
|
12 |
12 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
14 |
$0.00 |