| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,051 |
2,450 |
$171K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
438 |
430 |
$19K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,167 |
1,147 |
$12K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,098 |
1,071 |
$10K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
278 |
236 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
201 |
195 |
$3K |
| 99177 |
|
493 |
493 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
26 |
24 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
25 |
25 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
93 |
93 |
$2K |
| 0003A |
|
41 |
41 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
12 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
63 |
58 |
$1K |
| 0002A |
|
17 |
17 |
$779.96 |
| 0072A |
|
15 |
15 |
$688.20 |
| 0071A |
|
12 |
12 |
$550.56 |
| 90461 |
|
13 |
13 |
$511.68 |
| 85018 |
|
114 |
114 |
$243.23 |
| 91300 |
|
65 |
57 |
$0.31 |
| 91307 |
|
53 |
46 |
$0.15 |