| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
864 |
821 |
$35K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
297 |
283 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
76 |
76 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
172 |
170 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
18 |
18 |
$855.90 |
| 92558 |
|
208 |
207 |
$624.80 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$589.90 |
| 90461 |
|
36 |
35 |
$560.75 |
| 92567 |
|
41 |
40 |
$307.50 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
215 |
215 |
$159.36 |
| 3008F |
|
171 |
171 |
$0.00 |