| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
186 |
169 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
87 |
87 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
41 |
41 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
38 |
37 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
24 |
23 |
$2K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
120 |
116 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
108 |
108 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$992.64 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
33 |
32 |
$389.73 |
| 90670 |
|
15 |
15 |
$0.00 |
| 90655 |
|
12 |
12 |
$0.00 |
| 90461 |
|
21 |
21 |
$0.00 |
| 90698 |
|
13 |
13 |
$0.00 |
| 90680 |
|
12 |
12 |
$0.00 |