| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,002 |
849 |
$59K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
191 |
191 |
$16K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
513 |
412 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
141 |
140 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
55 |
55 |
$5K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
525 |
520 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
38 |
37 |
$3K |
| 96127 |
|
287 |
286 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
237 |
230 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
124 |
122 |
$1K |
| 90461 |
|
68 |
68 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$1K |
| 99177 |
|
14 |
14 |
$210.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
27 |
13 |
$177.15 |
| 90686 |
|
13 |
13 |
$0.00 |