| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
676 |
661 |
$39K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
328 |
327 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
563 |
562 |
$6K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
594 |
594 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
53 |
53 |
$4K |
| 99173 |
|
112 |
112 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
24 |
24 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$1K |
| 92551 |
|
78 |
78 |
$851.76 |
| 81002 |
|
89 |
89 |
$257.19 |