| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,074 |
10,240 |
$643K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,673 |
6,645 |
$155K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,615 |
1,614 |
$139K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,716 |
1,716 |
$139K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,605 |
1,603 |
$129K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,546 |
1,530 |
$117K |
| 99173 |
|
5,066 |
5,063 |
$113K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,316 |
1,291 |
$107K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
9,681 |
9,639 |
$97K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
9,685 |
9,642 |
$92K |
| 90461 |
|
6,104 |
3,294 |
$12K |
| 94760 |
|
2,522 |
2,397 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
53 |
53 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
347 |
342 |
$4K |
| 90651 |
|
701 |
701 |
$791.96 |
| 0072A |
|
15 |
15 |
$688.05 |
| 0071A |
|
15 |
15 |
$642.18 |
| 90658 |
|
3,018 |
3,016 |
$569.08 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
25 |
25 |
$417.12 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
32 |
30 |
$389.10 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
16 |
16 |
$158.84 |
| 90734 |
|
113 |
113 |
$105.51 |
| 94761 |
|
17 |
16 |
$54.56 |
| 96160 |
|
12 |
12 |
$21.84 |
| 90723 |
|
343 |
342 |
$0.00 |
| 90680 |
|
517 |
515 |
$0.00 |
| 90657 |
|
495 |
492 |
$0.00 |
| 90697 |
|
174 |
174 |
$0.00 |
| 90677 |
|
12 |
12 |
$0.00 |
| 90619 |
|
76 |
76 |
$0.00 |
| 91307 |
|
34 |
32 |
$0.00 |
| 90748 |
|
35 |
35 |
$0.00 |
| 90648 |
|
661 |
659 |
$0.00 |
| 90633 |
|
2,008 |
2,004 |
$0.00 |
| 90670 |
|
1,135 |
1,131 |
$0.00 |
| 90715 |
|
24 |
24 |
$0.00 |
| 99420 |
|
556 |
554 |
$0.00 |
| 90700 |
|
24 |
24 |
$0.00 |
| 90710 |
|
25 |
25 |
$0.00 |