| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
862 |
820 |
$57K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
112 |
112 |
$15K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
91 |
91 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
35 |
33 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
317 |
314 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
121 |
121 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
29 |
29 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
27 |
27 |
$2K |
| 90461 |
|
44 |
44 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
135 |
134 |
$1K |
| 99173 |
|
47 |
47 |
$1K |
| 96127 |
|
66 |
66 |
$688.09 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
36 |
36 |
$432.24 |
| 85018 |
|
12 |
12 |
$32.16 |