| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,537 |
5,160 |
$285K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
990 |
940 |
$69K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,903 |
2,897 |
$63K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,401 |
4,395 |
$45K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
3,661 |
3,633 |
$35K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
257 |
257 |
$21K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
196 |
196 |
$13K |
| 90461 |
|
723 |
723 |
$10K |
| 87428 |
|
132 |
130 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
541 |
528 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
140 |
140 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
54 |
54 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
273 |
273 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
90 |
85 |
$4K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
135 |
127 |
$4K |
| 81003 |
|
1,293 |
1,283 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
154 |
113 |
$3K |
| 99215 |
Prolong outpt/office vis |
16 |
13 |
$2K |
| 99051 |
|
49 |
49 |
$794.88 |
| 99177 |
|
227 |
226 |
$738.08 |
| 90686 |
|
557 |
554 |
$135.96 |
| 99000 |
|
343 |
325 |
$0.00 |
| 90674 |
|
13 |
13 |
$0.00 |