| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
564 |
534 |
$51K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,397 |
1,141 |
$41K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
284 |
274 |
$16K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,231 |
1,230 |
$11K |
| 96127 |
|
578 |
578 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
52 |
52 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
44 |
44 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
292 |
292 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
27 |
27 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 90461 |
|
19 |
19 |
$747.84 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
29 |
27 |
$347.69 |
| 85018 |
|
32 |
32 |
$69.12 |