| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,216 |
3,089 |
$164K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,572 |
1,536 |
$19K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,504 |
1,437 |
$17K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
354 |
343 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
58 |
58 |
$3K |
| 99460 |
|
58 |
58 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
233 |
233 |
$2K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
43 |
43 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
36 |
36 |
$2K |
| 90686 |
|
233 |
221 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
12 |
$845.74 |
| 99050 |
|
91 |
85 |
$742.50 |
| 99462 |
|
22 |
19 |
$551.92 |
| 96127 |
|
87 |
82 |
$158.59 |
| 99173 |
|
173 |
145 |
$119.77 |
| 99072 |
|
148 |
134 |
$0.00 |