| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,376 |
3,195 |
$197K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,379 |
3,643 |
$132K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
678 |
678 |
$57K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
506 |
506 |
$42K |
| 90461 |
|
868 |
867 |
$30K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
372 |
367 |
$30K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
3,054 |
3,042 |
$28K |
| 99050 |
|
1,391 |
1,345 |
$23K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
244 |
235 |
$22K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
198 |
198 |
$18K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,241 |
1,241 |
$13K |
| 92551 |
|
594 |
592 |
$5K |
| 99173 |
|
239 |
239 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
134 |
129 |
$5K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
92 |
90 |
$5K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
49 |
48 |
$4K |
| 0071A |
|
67 |
67 |
$3K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
379 |
374 |
$3K |
| 36416 |
|
241 |
238 |
$2K |
| 0072A |
|
45 |
45 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
93 |
92 |
$1K |
| 83655 |
|
80 |
80 |
$999.20 |
| 90691 |
|
15 |
15 |
$834.75 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
24 |
24 |
$563.28 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
25 |
25 |
$295.25 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
24 |
24 |
$262.80 |
| 85018 |
|
91 |
91 |
$194.32 |
| 86580 |
|
25 |
25 |
$159.50 |
| 99174 |
|
14 |
14 |
$64.26 |