| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
324 |
310 |
$20K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
130 |
130 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
51 |
50 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
33 |
33 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
192 |
191 |
$2K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
212 |
210 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16 |
16 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
31 |
30 |
$401.51 |
| 99050 |
|
17 |
17 |
$309.74 |
| 81002 |
|
14 |
14 |
$40.60 |
| 85018 |
|
14 |
14 |
$37.52 |