| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,563 |
1,904 |
$171K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
102 |
102 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
378 |
375 |
$4K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
378 |
375 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
33 |
33 |
$3K |
| 99401 |
|
100 |
98 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
244 |
232 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
133 |
124 |
$2K |
| 99443 |
|
69 |
52 |
$2K |
| 99051 |
|
112 |
108 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
14 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
15 |
$1K |
| 92552 |
|
14 |
14 |
$362.88 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
29 |
14 |
$337.16 |
| 99173 |
|
13 |
13 |
$292.63 |