| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,475 |
1,449 |
$86K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
392 |
384 |
$35K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
893 |
543 |
$24K |
| 92558 |
|
395 |
395 |
$18K |
| 99177 |
|
478 |
478 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
105 |
105 |
$9K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
929 |
929 |
$8K |
| 99051 |
|
483 |
475 |
$8K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
144 |
143 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
81 |
81 |
$7K |
| 96127 |
|
392 |
391 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
343 |
314 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
147 |
147 |
$3K |
| 90461 |
|
105 |
105 |
$3K |
| 92587 |
|
106 |
106 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
70 |
69 |
$836.30 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
34 |
33 |
$588.35 |
| 99000 |
|
15 |
14 |
$15.00 |
| 99072 |
|
61 |
61 |
$0.00 |