| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,026 |
2,897 |
$140K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,614 |
2,607 |
$78K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
605 |
566 |
$57K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,177 |
4,128 |
$44K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
3,414 |
3,380 |
$31K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
49 |
49 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
49 |
49 |
$5K |
| 90461 |
|
93 |
93 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
31 |
31 |
$3K |
| 0071A |
|
17 |
17 |
$779.79 |
| 90480 |
|
16 |
12 |
$688.05 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
30 |
29 |
$440.22 |
| 90686 |
|
513 |
513 |
$40.00 |
| 90658 |
|
39 |
39 |
$23.76 |
| 90661 |
|
115 |
115 |
$20.35 |
| 90687 |
|
12 |
12 |
$0.00 |
| 90670 |
|
29 |
29 |
$0.00 |
| 90698 |
|
24 |
24 |
$0.00 |
| 90688 |
|
372 |
372 |
$0.00 |
| 90660 |
|
14 |
14 |
$0.00 |
| 99000 |
|
73 |
71 |
$0.00 |
| 91307 |
|
68 |
68 |
$0.00 |