| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,110 |
1,000 |
$67K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
504 |
498 |
$19K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
803 |
797 |
$8K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
708 |
706 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
67 |
67 |
$6K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
65 |
64 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
26 |
26 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
106 |
106 |
$2K |
| 99173 |
|
56 |
56 |
$1K |
| 92551 |
|
110 |
110 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$958.77 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
68 |
65 |
$883.32 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
14 |
$538.50 |
| 85018 |
|
13 |
13 |
$34.84 |
| 81002 |
|
12 |
12 |
$34.80 |