| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
813 |
762 |
$57K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
119 |
111 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
347 |
343 |
$11K |
| 99173 |
|
209 |
209 |
$5K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
409 |
409 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
369 |
369 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
30 |
30 |
$3K |
| 92551 |
|
235 |
235 |
$3K |
| 0071A |
|
12 |
12 |
$480.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$162.96 |