| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,191 |
1,136 |
$68K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
675 |
489 |
$20K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
775 |
775 |
$7K |
| 96127 |
|
478 |
477 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
55 |
55 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
43 |
43 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
40 |
40 |
$3K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
38 |
38 |
$3K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
76 |
75 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
191 |
190 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
24 |
24 |
$2K |
| 90461 |
|
43 |
43 |
$1K |
| 87081 |
|
143 |
142 |
$978.12 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
87 |
85 |
$893.49 |
| 99051 |
|
36 |
36 |
$596.16 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
20 |
19 |
$460.59 |
| 94760 |
|
30 |
30 |
$75.90 |