| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
123 |
119 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
42 |
40 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
39 |
38 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
48 |
48 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
80 |
80 |
$888.12 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
85 |
85 |
$767.85 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
30 |
28 |
$389.70 |
| 92551 |
|
32 |
32 |
$338.37 |
| 99173 |
|
12 |
12 |
$297.12 |