| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,029 |
14,694 |
$208K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,076 |
3,013 |
$69K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
6,075 |
6,061 |
$48K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
732 |
728 |
$34K |
| 96127 |
|
2,959 |
2,674 |
$31K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
1,052 |
1,045 |
$29K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,655 |
2,164 |
$27K |
| 92558 |
|
3,334 |
3,325 |
$22K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,087 |
3,358 |
$18K |
| T1015 |
Clinic visit/encounter, all-inclusive |
71 |
70 |
$12K |
| 99177 |
|
3,142 |
3,128 |
$11K |
| 99051 |
|
1,964 |
1,937 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
631 |
631 |
$7K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
75 |
74 |
$6K |
| 90480 |
|
147 |
145 |
$5K |
| 92587 |
|
386 |
255 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
371 |
371 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
266 |
262 |
$3K |
| T1502 |
Administration of oral, intramuscular and/or subcutaneous medication by health care agency/professional, per visit |
48 |
13 |
$3K |
| 90834 |
Psychotherapy, 45 minutes with patient |
14 |
12 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
74 |
74 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
349 |
349 |
$2K |
| 99188 |
|
51 |
51 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
215 |
215 |
$788.84 |
| 87634 |
|
13 |
13 |
$681.12 |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
15 |
12 |
$499.35 |
| 90686 |
|
313 |
313 |
$211.49 |
| 90656 |
|
368 |
367 |
$138.87 |
| 96160 |
|
98 |
93 |
$61.65 |
| 81002 |
|
20 |
20 |
$55.41 |
| 99000 |
|
103 |
102 |
$49.50 |
| 90680 |
|
13 |
13 |
$0.00 |
| 90677 |
|
79 |
79 |
$0.00 |
| 90697 |
|
40 |
40 |
$0.00 |
| 91319 |
|
14 |
14 |
$0.00 |
| 99072 |
|
273 |
262 |
$0.00 |