| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,451 |
3,208 |
$35K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
2,239 |
2,230 |
$17K |
| 96127 |
|
1,168 |
1,166 |
$12K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
925 |
773 |
$10K |
| 99188 |
|
255 |
252 |
$7K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
189 |
186 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,802 |
1,549 |
$6K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
352 |
180 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
329 |
324 |
$5K |
| 92551 |
|
144 |
143 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
416 |
401 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
386 |
386 |
$745.74 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
234 |
231 |
$625.28 |
| 90461 |
|
12 |
12 |
$520.00 |
| 99177 |
|
125 |
124 |
$460.68 |
| 99173 |
|
665 |
663 |
$382.67 |
| 90480 |
|
12 |
12 |
$366.96 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
204 |
204 |
$332.60 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
28 |
26 |
$285.60 |
| 99050 |
|
14 |
13 |
$175.32 |
| 94760 |
|
99 |
81 |
$174.57 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
45 |
45 |
$90.89 |
| 85018 |
|
12 |
12 |
$25.08 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
28 |
28 |
$20.45 |
| 99051 |
|
28 |
28 |
$16.56 |
| 99072 |
|
46 |
39 |
$0.00 |
| 90680 |
|
131 |
131 |
$0.00 |
| 90697 |
|
156 |
156 |
$0.00 |
| 90677 |
|
195 |
195 |
$0.00 |
| 90656 |
|
267 |
266 |
$0.00 |
| 90686 |
|
124 |
124 |
$0.00 |
| 99000 |
|
13 |
13 |
$0.00 |
| 90688 |
|
27 |
27 |
$0.00 |