| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,659 |
2,605 |
$149K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,191 |
1,158 |
$113K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,647 |
1,259 |
$59K |
| 92558 |
|
839 |
838 |
$29K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
538 |
535 |
$28K |
| 99177 |
|
932 |
932 |
$20K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
233 |
233 |
$19K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,818 |
1,814 |
$16K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,169 |
937 |
$12K |
| 90461 |
|
342 |
342 |
$11K |
| 96127 |
|
828 |
784 |
$10K |
| 99051 |
|
552 |
543 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
94 |
94 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
88 |
88 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
222 |
220 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
37 |
37 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
126 |
126 |
$3K |
| 92587 |
|
142 |
139 |
$2K |
| 0071A |
|
33 |
33 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
119 |
118 |
$1K |
| 0072A |
|
28 |
28 |
$1K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
12 |
12 |
$369.23 |
| 99188 |
|
12 |
12 |
$312.00 |
| 92552 |
|
12 |
12 |
$309.00 |
| 99072 |
|
86 |
84 |
$0.00 |