| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
924 |
771 |
$60K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
383 |
382 |
$19K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
143 |
143 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
139 |
139 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
125 |
125 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
102 |
97 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
557 |
555 |
$6K |
| 90461 |
|
173 |
173 |
$6K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
552 |
550 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
51 |
51 |
$5K |
| 99173 |
|
107 |
107 |
$3K |
| 99174 |
|
56 |
56 |
$1K |
| 83655 |
|
53 |
53 |
$719.09 |
| 92551 |
|
29 |
29 |
$303.26 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
13 |
$289.77 |
| 85018 |
|
95 |
95 |
$254.65 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$170.05 |
| 90648 |
|
13 |
13 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |
| 90686 |
|
107 |
107 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |