| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,156 |
1,055 |
$67K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
958 |
954 |
$33K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
305 |
298 |
$25K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
229 |
229 |
$19K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
222 |
222 |
$19K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,452 |
1,440 |
$14K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,125 |
1,123 |
$13K |
| 99173 |
|
294 |
294 |
$7K |
| 92551 |
|
616 |
615 |
$7K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
71 |
71 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
59 |
57 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
101 |
101 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
88 |
87 |
$1K |
| 85018 |
|
139 |
138 |
$372.28 |