| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,979 |
8,164 |
$805K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
886 |
868 |
$83K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,463 |
2,334 |
$50K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,158 |
2,124 |
$22K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
213 |
213 |
$21K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
221 |
219 |
$20K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
2,102 |
2,069 |
$20K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
161 |
144 |
$14K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,015 |
1,003 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
121 |
120 |
$11K |
| 99050 |
|
118 |
107 |
$2K |
| 85018 |
|
388 |
386 |
$854.61 |
| 90688 |
|
72 |
72 |
$0.00 |
| 90698 |
|
17 |
17 |
$0.00 |
| 90686 |
|
12 |
12 |
$0.00 |
| 90651 |
|
18 |
18 |
$0.00 |
| 90715 |
|
13 |
13 |
$0.00 |
| 90700 |
|
13 |
13 |
$0.00 |
| 90461 |
|
39 |
39 |
$0.00 |
| 90670 |
|
26 |
26 |
$0.00 |
| 90734 |
|
25 |
25 |
$0.00 |