| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
860 |
841 |
$50K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
541 |
528 |
$46K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
606 |
335 |
$14K |
| 92558 |
|
228 |
228 |
$10K |
| 99177 |
|
312 |
312 |
$8K |
| 99051 |
|
445 |
439 |
$7K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
580 |
580 |
$5K |
| 0072A |
|
94 |
94 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
203 |
203 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
44 |
44 |
$4K |
| 96127 |
|
283 |
282 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
26 |
26 |
$2K |
| 92587 |
|
110 |
107 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
142 |
141 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
158 |
149 |
$2K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
25 |
25 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
14 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
17 |
17 |
$606.90 |
| 90461 |
|
15 |
15 |
$492.00 |
| 90686 |
|
13 |
13 |
$46.69 |
| 99072 |
|
113 |
112 |
$0.00 |