| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,177 |
2,008 |
$113K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,108 |
1,103 |
$11K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
338 |
321 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
152 |
152 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
254 |
254 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
25 |
25 |
$1K |
| 0071A |
|
20 |
20 |
$917.40 |
| 0072A |
|
18 |
18 |
$825.66 |
| 90461 |
|
24 |
24 |
$724.20 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
13 |
13 |
$667.03 |
| 96127 |
|
39 |
38 |
$267.02 |
| 99441 |
|
16 |
13 |
$172.32 |
| 99072 |
|
35 |
34 |
$0.00 |
| 90686 |
|
342 |
342 |
$0.00 |
| 91307 |
|
38 |
38 |
$0.00 |