| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,638 |
8,288 |
$447K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,961 |
7,906 |
$205K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,306 |
2,306 |
$166K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,000 |
2,000 |
$156K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
11,931 |
11,851 |
$114K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,311 |
1,301 |
$101K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,092 |
1,092 |
$82K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
7,872 |
7,868 |
$81K |
| 96127 |
|
2,894 |
2,892 |
$30K |
| 90461 |
|
1,730 |
1,727 |
$28K |
| 87081 |
|
135 |
135 |
$778.91 |
| 0071A |
|
16 |
16 |
$733.92 |
| 0072A |
|
16 |
16 |
$733.92 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$189.54 |
| 92551 |
|
12 |
12 |
$119.16 |
| 90686 |
|
2,655 |
2,654 |
$20.53 |
| 90648 |
|
534 |
534 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 90670 |
|
685 |
684 |
$0.00 |
| 90633 |
|
24 |
24 |
$0.00 |
| 90723 |
|
148 |
148 |
$0.00 |
| 90651 |
|
138 |
138 |
$0.00 |
| 90680 |
|
191 |
190 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
386 |
386 |
$0.00 |
| 90677 |
|
38 |
37 |
$0.00 |
| 90697 |
|
37 |
37 |
$0.00 |
| 90619 |
|
14 |
14 |
$0.00 |
| 91307 |
|
41 |
40 |
$0.00 |