| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,097 |
1,044 |
$61K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
300 |
298 |
$32K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
687 |
612 |
$27K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,310 |
1,307 |
$12K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
951 |
934 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
65 |
65 |
$5K |
| 92551 |
|
573 |
573 |
$5K |
| 99173 |
|
192 |
192 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
189 |
186 |
$4K |
| 96127 |
|
272 |
267 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
37 |
37 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
26 |
26 |
$2K |
| 87428 |
|
38 |
37 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$1K |
| 90461 |
|
30 |
30 |
$905.28 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
49 |
31 |
$767.13 |
| 0071A |
|
12 |
12 |
$550.56 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
13 |
13 |
$305.11 |
| 99177 |
|
12 |
12 |
$197.66 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$141.72 |