| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,916 |
2,489 |
$207K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,818 |
1,482 |
$63K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
553 |
553 |
$55K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
548 |
528 |
$52K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
450 |
450 |
$45K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
327 |
327 |
$35K |
| 92552 |
|
1,033 |
1,033 |
$29K |
| 90461 |
|
728 |
655 |
$25K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,917 |
1,914 |
$21K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
2,022 |
1,975 |
$20K |
| 99173 |
|
772 |
771 |
$15K |
| 99188 |
|
382 |
382 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
108 |
103 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
795 |
781 |
$10K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
139 |
137 |
$2K |
| S3005 |
Performance measurement, evaluation of patient self assessment, depression |
138 |
133 |
$2K |
| 87807 |
|
34 |
33 |
$437.58 |
| 81002 |
|
15 |
15 |
$43.20 |
| 90649 |
|
79 |
79 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |
| 90734 |
|
52 |
52 |
$0.00 |
| 90670 |
|
417 |
416 |
$0.00 |
| 90633 |
|
56 |
56 |
$0.00 |
| 90685 |
|
35 |
35 |
$0.00 |
| 90707 |
|
13 |
13 |
$0.00 |
| 90744 |
|
128 |
128 |
$0.00 |
| 90680 |
|
247 |
246 |
$0.00 |
| 90688 |
|
308 |
308 |
$0.00 |
| 90698 |
|
364 |
363 |
$0.00 |