| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,072 |
3,194 |
$263K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
403 |
403 |
$38K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,264 |
1,255 |
$27K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,064 |
1,904 |
$26K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
258 |
257 |
$25K |
| 99188 |
|
691 |
690 |
$19K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,734 |
1,730 |
$17K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,444 |
1,443 |
$16K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
539 |
533 |
$12K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
494 |
494 |
$10K |
| 99173 |
|
706 |
705 |
$10K |
| 92551 |
|
1,000 |
999 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
74 |
74 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
63 |
63 |
$6K |
| 90461 |
|
145 |
145 |
$3K |
| 96127 |
|
89 |
89 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
77 |
38 |
$973.52 |
| 92015 |
Determination of refractive state |
81 |
81 |
$513.87 |
| 90651 |
|
27 |
27 |
$0.00 |
| 99000 |
|
401 |
390 |
$0.00 |
| 90688 |
|
555 |
555 |
$0.00 |
| 90686 |
|
396 |
396 |
$0.00 |
| 90744 |
|
12 |
12 |
$0.00 |
| 90670 |
|
40 |
40 |
$0.00 |
| 90700 |
|
13 |
13 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |