| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
114 |
97 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
29 |
29 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
27 |
27 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
82 |
62 |
$2K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
75 |
73 |
$791.29 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
66 |
66 |
$749.27 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
29 |
18 |
$411.45 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
19 |
17 |
$259.37 |