| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,235 |
2,993 |
$309K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,770 |
1,677 |
$120K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
701 |
699 |
$72K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
623 |
622 |
$58K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,328 |
1,309 |
$52K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
341 |
341 |
$32K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,569 |
2,542 |
$28K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
163 |
158 |
$14K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,335 |
1,324 |
$13K |
| 81002 |
|
2,656 |
2,631 |
$8K |
| 85018 |
|
2,333 |
2,324 |
$5K |
| 92567 |
|
306 |
297 |
$4K |
| 99442 |
|
77 |
69 |
$2K |
| 99443 |
|
14 |
12 |
$465.50 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
34 |
34 |
$428.09 |
| 90658 |
|
75 |
75 |
$0.00 |
| 90461 |
|
76 |
76 |
$0.00 |
| 90713 |
|
27 |
27 |
$0.00 |
| 90700 |
|
39 |
38 |
$0.00 |
| 90734 |
|
16 |
16 |
$0.00 |