| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
725 |
702 |
$42K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
614 |
610 |
$31K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
341 |
334 |
$30K |
| 92558 |
|
410 |
410 |
$19K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
191 |
191 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
170 |
170 |
$14K |
| 99177 |
|
404 |
404 |
$12K |
| 90461 |
|
294 |
291 |
$9K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
138 |
136 |
$7K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
779 |
778 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
596 |
451 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
251 |
251 |
$5K |
| 96127 |
|
276 |
271 |
$3K |
| 99051 |
|
163 |
162 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
25 |
25 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
121 |
120 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
48 |
48 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
13 |
13 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
53 |
52 |
$641.93 |
| 99000 |
|
12 |
12 |
$12.00 |
| 99072 |
|
88 |
88 |
$0.00 |