| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,286 |
2,199 |
$133K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,071 |
991 |
$51K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,794 |
1,787 |
$16K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,361 |
1,354 |
$14K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
147 |
144 |
$11K |
| 90461 |
|
309 |
309 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
122 |
122 |
$10K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
81 |
80 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
85 |
85 |
$7K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
173 |
171 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
30 |
30 |
$3K |
| 99051 |
|
136 |
136 |
$2K |
| 96127 |
|
174 |
173 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
66 |
66 |
$1K |
| 99177 |
|
12 |
12 |
$216.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$141.72 |
| 99000 |
|
87 |
87 |
$93.00 |
| 85018 |
|
38 |
38 |
$85.44 |
| 94760 |
|
16 |
14 |
$40.48 |