| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
857 |
841 |
$50K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
460 |
428 |
$20K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
477 |
471 |
$17K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,221 |
1,221 |
$11K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
840 |
835 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
74 |
74 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
37 |
37 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
142 |
142 |
$3K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
90 |
90 |
$2K |
| 90461 |
|
40 |
40 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$1K |
| 0072A |
|
18 |
18 |
$825.84 |
| 99051 |
|
47 |
47 |
$778.32 |
| 0071A |
|
12 |
12 |
$550.56 |
| 96127 |
|
25 |
25 |
$297.83 |
| 85018 |
|
37 |
37 |
$79.92 |
| 94760 |
|
14 |
14 |
$27.72 |
| 99000 |
|
14 |
14 |
$16.00 |