| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,711 |
3,550 |
$29K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
597 |
590 |
$18K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,891 |
1,888 |
$15K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,069 |
1,024 |
$12K |
| 96127 |
|
1,079 |
1,069 |
$11K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
44 |
44 |
$6K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
39 |
39 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,826 |
1,058 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
147 |
145 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
16 |
16 |
$718.34 |
| 90480 |
|
26 |
26 |
$596.31 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
150 |
150 |
$389.44 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
64 |
64 |
$249.45 |
| 92551 |
|
13 |
13 |
$104.72 |
| 90686 |
|
56 |
56 |
$40.00 |
| 90656 |
|
205 |
201 |
$0.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
70 |
70 |
$0.00 |
| 99072 |
|
212 |
186 |
$0.00 |
| 90661 |
|
32 |
31 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
39 |
39 |
$0.00 |