| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
724 |
688 |
$43K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
492 |
492 |
$19K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
107 |
107 |
$9K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
760 |
760 |
$8K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
611 |
611 |
$7K |
| 99173 |
|
149 |
149 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
40 |
40 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
25 |
25 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
26 |
25 |
$2K |
| 81002 |
|
243 |
241 |
$691.11 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
44 |
44 |
$578.16 |
| 92551 |
|
41 |
41 |
$446.08 |