| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
603 |
576 |
$45K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
798 |
753 |
$43K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
298 |
298 |
$16K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
191 |
191 |
$11K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
495 |
494 |
$9K |
| 92587 |
|
263 |
261 |
$6K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
630 |
630 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
230 |
227 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
39 |
39 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
157 |
154 |
$2K |
| 90461 |
|
14 |
14 |
$145.00 |
| 90656 |
|
12 |
12 |
$17.01 |
| 99000 |
|
28 |
28 |
$0.00 |