| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
991 |
947 |
$58K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,733 |
644 |
$36K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
287 |
276 |
$24K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
283 |
277 |
$23K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
250 |
250 |
$21K |
| 90461 |
|
394 |
394 |
$13K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
851 |
843 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
69 |
69 |
$6K |
| 99173 |
|
241 |
240 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
516 |
513 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
48 |
48 |
$4K |
| 96127 |
|
364 |
361 |
$4K |
| 99051 |
|
132 |
132 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
71 |
71 |
$1K |
| 99188 |
|
45 |
45 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
58 |
58 |
$684.98 |
| 99177 |
|
16 |
16 |
$264.00 |
| 94760 |
|
44 |
43 |
$113.85 |