| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,941 |
3,627 |
$40K |
| 90834 |
Psychotherapy, 45 minutes with patient |
117 |
86 |
$27K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
2,329 |
2,322 |
$17K |
| 96127 |
|
1,106 |
1,105 |
$11K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,030 |
1,024 |
$11K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,149 |
1,804 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
664 |
633 |
$10K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
167 |
166 |
$8K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
193 |
189 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
423 |
409 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
436 |
436 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
209 |
209 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
536 |
535 |
$5K |
| 92551 |
|
458 |
452 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
216 |
213 |
$3K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
31 |
30 |
$3K |
| 87428 |
|
38 |
38 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
156 |
156 |
$2K |
| 85018 |
|
475 |
474 |
$1K |
| 90461 |
|
27 |
27 |
$819.00 |
| 92552 |
|
29 |
29 |
$773.85 |
| 99173 |
|
334 |
331 |
$772.26 |
| 87807 |
|
43 |
42 |
$483.37 |
| 81002 |
|
149 |
146 |
$457.43 |
| 83655 |
|
31 |
31 |
$433.84 |
| 99188 |
|
14 |
12 |
$364.00 |
| 90686 |
|
148 |
147 |
$0.02 |
| 99072 |
|
165 |
142 |
$0.00 |
| 90633 |
|
62 |
62 |
$0.00 |
| 90661 |
|
116 |
112 |
$0.00 |
| 90660 |
|
13 |
13 |
$0.00 |
| 90677 |
|
27 |
27 |
$0.00 |
| 90656 |
|
34 |
34 |
$0.00 |