| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,620 |
1,528 |
$101K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,013 |
1,010 |
$40K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
305 |
305 |
$28K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
281 |
281 |
$26K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,319 |
1,318 |
$15K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,433 |
1,425 |
$14K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
147 |
147 |
$12K |
| 99173 |
|
378 |
378 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
72 |
72 |
$7K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27 |
26 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
138 |
138 |
$2K |
| 92551 |
|
180 |
178 |
$2K |
| 81002 |
|
367 |
365 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
77 |
77 |
$996.82 |
| 99050 |
|
19 |
19 |
$328.50 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24 |
12 |
$322.80 |
| 85018 |
|
25 |
25 |
$62.68 |