| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,115 |
961 |
$429K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
598 |
502 |
$263K |
| X5622 |
|
179 |
158 |
$51K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
123 |
122 |
$51K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
81 |
79 |
$38K |
| 99441 |
|
17 |
14 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
464 |
412 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
117 |
102 |
$0.00 |
| 91307 |
|
37 |
36 |
$0.00 |
| 99000 |
|
73 |
71 |
$0.00 |
| 90686 |
|
122 |
113 |
$0.00 |
| 36416 |
|
47 |
43 |
$0.00 |
| 96127 |
|
12 |
12 |
$0.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
55 |
42 |
$0.00 |
| 0001A |
|
15 |
15 |
$0.00 |
| 0012A |
|
17 |
15 |
$0.00 |
| 0081A |
|
16 |
16 |
$0.00 |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
15 |
15 |
$0.00 |
| 0031A |
|
13 |
12 |
$0.00 |
| 0011A |
|
17 |
17 |
$0.00 |
| 92551 |
|
12 |
12 |
$0.00 |
| 91305 |
|
13 |
12 |
$0.00 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
429 |
370 |
$0.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
28 |
28 |
$0.00 |
| T1015 |
Clinic visit/encounter, all-inclusive |
59 |
59 |
$0.00 |
| 99188 |
|
117 |
104 |
$0.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
123 |
112 |
$0.00 |
| 90670 |
|
17 |
13 |
$0.00 |
| 99173 |
|
27 |
27 |
$0.00 |
| 99072 |
|
51 |
45 |
$0.00 |
| 91308 |
|
16 |
16 |
$0.00 |
| 0071A |
|
15 |
14 |
$0.00 |
| 81025 |
|
13 |
12 |
$0.00 |