| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,850 |
1,826 |
$14K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,496 |
2,421 |
$12K |
| 90832 |
Psychotherapy, 30 minutes with patient |
56 |
44 |
$8K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
467 |
378 |
$5K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
100 |
100 |
$5K |
| 96127 |
|
430 |
416 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
796 |
753 |
$4K |
| 90480 |
|
61 |
61 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,810 |
973 |
$1K |
| 92551 |
|
53 |
49 |
$505.21 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
12 |
12 |
$324.88 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
15 |
$160.38 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
25 |
25 |
$82.86 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$66.44 |
| 99177 |
|
16 |
16 |
$59.52 |
| 85018 |
|
12 |
12 |
$22.99 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
82 |
82 |
$20.45 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
25 |
25 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$0.00 |
| 99072 |
|
19 |
16 |
$0.00 |
| 90686 |
|
13 |
12 |
$0.00 |
| 90656 |
|
236 |
235 |
$0.00 |