| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,335 |
1,887 |
$135K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
361 |
361 |
$16K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,044 |
1,040 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
567 |
567 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
131 |
131 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$994.32 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
46 |
43 |
$629.65 |