| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
304 |
289 |
$18K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
397 |
289 |
$11K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
342 |
338 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
26 |
25 |
$2K |
| 96127 |
|
163 |
161 |
$2K |
| 99173 |
|
65 |
65 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
17 |
17 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
25 |
25 |
$876.30 |
| 0071A |
|
19 |
19 |
$871.72 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
73 |
72 |
$747.57 |
| 0072A |
|
14 |
14 |
$642.32 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
41 |
41 |
$539.29 |
| 81002 |
|
98 |
98 |
$252.07 |