| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,908 |
6,654 |
$237K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,169 |
2,093 |
$45K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,178 |
899 |
$37K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
4,046 |
4,040 |
$36K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,868 |
2,667 |
$30K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
950 |
942 |
$30K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
814 |
814 |
$28K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
992 |
992 |
$26K |
| 96127 |
|
1,489 |
1,472 |
$13K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
461 |
461 |
$11K |
| 90461 |
|
176 |
176 |
$6K |
| 99173 |
|
124 |
124 |
$3K |
| 92587 |
|
58 |
58 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
29 |
29 |
$2K |
| 85018 |
|
591 |
591 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
98 |
98 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
71 |
34 |
$657.69 |
| 36416 |
|
15 |
15 |
$0.00 |