| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,138 |
1,100 |
$67K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
630 |
383 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
113 |
113 |
$9K |
| 99173 |
|
327 |
326 |
$7K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
729 |
725 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
66 |
64 |
$6K |
| 96127 |
|
411 |
411 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
49 |
49 |
$4K |
| 90461 |
|
46 |
46 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
136 |
135 |
$1K |
| 99051 |
|
69 |
69 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
93 |
90 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
34 |
34 |
$695.30 |
| 94760 |
|
218 |
208 |
$561.66 |