| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,183 |
1,093 |
$83K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
809 |
808 |
$30K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
273 |
256 |
$27K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,024 |
1,020 |
$12K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,029 |
1,026 |
$11K |
| 99173 |
|
369 |
369 |
$9K |
| 92551 |
|
378 |
378 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$176.54 |