| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,934 |
1,900 |
$111K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
630 |
612 |
$59K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,216 |
775 |
$35K |
| 92558 |
|
588 |
588 |
$27K |
| 99177 |
|
638 |
638 |
$18K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
155 |
155 |
$13K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,256 |
1,256 |
$11K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
209 |
208 |
$11K |
| 99051 |
|
581 |
568 |
$10K |
| 96127 |
|
660 |
648 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
83 |
83 |
$7K |
| 90461 |
|
224 |
224 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
551 |
486 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
156 |
156 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
30 |
30 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
128 |
127 |
$2K |
| 92587 |
|
111 |
109 |
$2K |
| 0071A |
|
32 |
32 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
75 |
75 |
$892.55 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
12 |
12 |
$355.56 |
| 99188 |
|
12 |
12 |
$312.00 |
| 99000 |
|
14 |
14 |
$14.00 |
| 99072 |
|
43 |
42 |
$0.00 |