| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
324 |
320 |
$19K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
122 |
119 |
$14K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
200 |
199 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
71 |
71 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
54 |
54 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
57 |
57 |
$4K |
| 90461 |
|
108 |
108 |
$4K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
378 |
377 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
243 |
243 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 96127 |
|
87 |
87 |
$893.49 |
| 99051 |
|
39 |
39 |
$645.84 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
30 |
30 |
$613.50 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
20 |
20 |
$469.20 |
| 92587 |
|
13 |
13 |
$225.03 |
| 85018 |
|
78 |
78 |
$164.28 |
| 99177 |
|
13 |
13 |
$48.36 |