| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,696 |
4,571 |
$450K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,500 |
1,996 |
$275K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
3,601 |
2,916 |
$135K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,401 |
1,185 |
$134K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,268 |
1,076 |
$115K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,053 |
856 |
$91K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
627 |
506 |
$68K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,158 |
926 |
$47K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,039 |
834 |
$44K |
| 90686 |
|
1,311 |
1,024 |
$22K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,696 |
2,173 |
$21K |
| 97803 |
|
1,501 |
1,266 |
$21K |
| 92551 |
|
2,460 |
2,046 |
$20K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,714 |
1,376 |
$20K |
| 90700 |
|
899 |
760 |
$17K |
| 90713 |
|
704 |
600 |
$14K |
| 96127 |
|
3,367 |
2,814 |
$13K |
| 90648 |
|
654 |
563 |
$13K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
420 |
334 |
$11K |
| 90670 |
|
475 |
419 |
$10K |
| 90677 |
|
265 |
206 |
$7K |
| 90680 |
|
324 |
289 |
$7K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
96 |
48 |
$6K |
| 99173 |
|
2,504 |
2,074 |
$5K |
| 90656 |
|
207 |
205 |
$5K |
| 96160 |
|
3,053 |
2,058 |
$5K |
| D1206 |
Topical application of fluoride varnish |
157 |
157 |
$4K |
| 0072A |
|
93 |
92 |
$4K |
| 0071A |
|
84 |
83 |
$3K |
| 90651 |
|
169 |
140 |
$3K |
| 90480 |
|
101 |
66 |
$3K |
| 90707 |
|
148 |
115 |
$3K |
| 90633 |
|
124 |
105 |
$2K |
| 90716 |
|
120 |
105 |
$2K |
| 90380 |
|
25 |
13 |
$2K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
300 |
186 |
$2K |
| 90744 |
|
110 |
80 |
$2K |
| 91319 |
|
37 |
25 |
$1K |
| 96161 |
|
590 |
509 |
$1K |
| 0081A |
|
33 |
32 |
$1K |
| 90734 |
|
46 |
42 |
$1K |
| 91320 |
|
24 |
14 |
$998.78 |
| 90698 |
|
42 |
42 |
$977.76 |
| 0082A |
|
23 |
19 |
$800.00 |
| 99406 |
|
163 |
102 |
$717.27 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
539 |
421 |
$714.00 |
| 0053A |
|
17 |
17 |
$680.00 |
| 91318 |
|
19 |
12 |
$611.52 |
| 0073A |
|
18 |
15 |
$560.00 |
| 90619 |
|
39 |
25 |
$535.44 |
| 90620 |
|
17 |
16 |
$372.48 |
| 99408 |
|
162 |
101 |
$343.00 |
| 91307 |
|
119 |
101 |
$0.09 |
| 91308 |
|
17 |
12 |
$0.00 |
| 99072 |
|
80 |
77 |
$0.00 |
| 99000 |
|
117 |
110 |
$0.00 |