| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
860 |
749 |
$56K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
191 |
171 |
$17K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
387 |
384 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,220 |
903 |
$12K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
887 |
885 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
61 |
61 |
$5K |
| 99051 |
|
228 |
205 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
81 |
79 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
32 |
32 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
39 |
37 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
30 |
30 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
117 |
114 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
87 |
49 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
88 |
82 |
$963.60 |
| 99188 |
|
28 |
28 |
$642.30 |
| 99173 |
|
33 |
33 |
$598.54 |
| 92552 |
|
17 |
17 |
$434.91 |
| 83655 |
|
28 |
27 |
$362.12 |
| 92567 |
|
24 |
23 |
$271.62 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
12 |
12 |
$232.76 |
| 96127 |
|
68 |
51 |
$212.98 |
| 87807 |
|
12 |
12 |
$147.62 |
| 81002 |
|
13 |
12 |
$36.01 |
| 91307 |
|
14 |
14 |
$0.14 |
| 90686 |
|
27 |
27 |
$0.00 |