| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,357 |
1,237 |
$73K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
984 |
972 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
92 |
92 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
69 |
69 |
$6K |
| 99173 |
|
287 |
287 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
367 |
363 |
$3K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
385 |
382 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
177 |
177 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
24 |
24 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$980.16 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$383.18 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
25 |
24 |
$291.06 |
| 90658 |
|
263 |
263 |
$194.79 |