| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,920 |
2,869 |
$160K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,625 |
1,592 |
$153K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,023 |
1,553 |
$68K |
| 92558 |
|
1,224 |
1,223 |
$46K |
| 99177 |
|
1,384 |
1,384 |
$31K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
314 |
314 |
$26K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
496 |
495 |
$25K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
2,173 |
2,173 |
$20K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
202 |
202 |
$17K |
| 90461 |
|
478 |
478 |
$14K |
| 96127 |
|
1,266 |
1,237 |
$14K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,127 |
961 |
$12K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
125 |
125 |
$11K |
| 99051 |
|
636 |
628 |
$11K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
108 |
108 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
172 |
172 |
$3K |
| 0071A |
|
63 |
63 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
224 |
222 |
$3K |
| 92587 |
|
140 |
137 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
128 |
128 |
$2K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
14 |
14 |
$1K |
| 0072A |
|
23 |
23 |
$1K |
| 0081A |
|
15 |
15 |
$688.20 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
13 |
13 |
$402.35 |
| 99188 |
|
12 |
12 |
$312.00 |
| 99000 |
|
39 |
39 |
$39.00 |
| 99072 |
|
105 |
104 |
$0.00 |