| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,157 |
2,909 |
$192K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,038 |
987 |
$86K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,799 |
1,780 |
$43K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,980 |
1,973 |
$20K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
2,056 |
2,055 |
$20K |
| 99173 |
|
673 |
673 |
$15K |
| 92551 |
|
674 |
674 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
64 |
64 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
44 |
44 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
24 |
24 |
$2K |
| 90461 |
|
86 |
86 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
17 |
16 |
$188.96 |