| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,509 |
1,427 |
$95K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
955 |
953 |
$38K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
276 |
276 |
$25K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
190 |
190 |
$17K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
191 |
188 |
$16K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,233 |
1,230 |
$14K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,393 |
1,379 |
$14K |
| 99173 |
|
253 |
253 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
251 |
248 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
28 |
28 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
136 |
136 |
$2K |
| 81002 |
|
479 |
467 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
15 |
$1K |
| 92551 |
|
105 |
105 |
$1K |
| 99050 |
|
12 |
12 |
$218.64 |
| 85018 |
|
70 |
70 |
$187.60 |