| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,783 |
1,592 |
$107K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
743 |
430 |
$20K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
651 |
637 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
70 |
66 |
$6K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
517 |
501 |
$5K |
| 92587 |
|
100 |
100 |
$5K |
| 90461 |
|
113 |
113 |
$4K |
| 99177 |
|
129 |
128 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
36 |
36 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
235 |
228 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
26 |
$2K |
| 99173 |
|
80 |
80 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
70 |
70 |
$1K |
| 87081 |
|
100 |
95 |
$894.08 |
| 96127 |
|
63 |
63 |
$647.01 |
| 99050 |
|
39 |
39 |
$645.84 |
| 94760 |
|
126 |
116 |
$498.87 |
| 87430 |
|
27 |
26 |
$486.72 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
27 |
26 |
$325.17 |
| 92551 |
|
26 |
26 |
$258.18 |
| 85018 |
|
14 |
13 |
$30.24 |