| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,669 |
1,521 |
$102K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
785 |
777 |
$31K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
274 |
270 |
$23K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
192 |
191 |
$17K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,209 |
1,203 |
$14K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
148 |
147 |
$13K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,139 |
1,134 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
46 |
45 |
$4K |
| 92551 |
|
300 |
299 |
$3K |
| 99173 |
|
115 |
115 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
26 |
26 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
116 |
115 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
143 |
135 |
$2K |
| 81002 |
|
331 |
326 |
$951.16 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
24 |
13 |
$295.90 |
| 99050 |
|
13 |
13 |
$234.13 |
| 85018 |
|
45 |
45 |
$117.90 |