| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,494 |
1,347 |
$93K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
909 |
906 |
$37K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
193 |
193 |
$18K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
191 |
191 |
$17K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,323 |
1,317 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
147 |
144 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
781 |
777 |
$9K |
| 99173 |
|
243 |
243 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
121 |
121 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
16 |
$2K |
| 92551 |
|
114 |
114 |
$1K |
| 90461 |
|
12 |
12 |
$373.92 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$161.16 |
| 85018 |
|
54 |
54 |
$132.92 |
| 81002 |
|
12 |
12 |
$34.80 |
| 96127 |
|
82 |
82 |
$0.00 |