| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,522 |
1,479 |
$85K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
588 |
571 |
$52K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,083 |
912 |
$33K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,268 |
1,267 |
$11K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
121 |
120 |
$6K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
175 |
173 |
$6K |
| 96127 |
|
488 |
488 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
45 |
45 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
357 |
355 |
$4K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
43 |
43 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
162 |
162 |
$3K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
101 |
101 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
30 |
30 |
$3K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
31 |
31 |
$2K |
| 90461 |
|
53 |
53 |
$2K |
| 99050 |
|
88 |
87 |
$1K |
| 0072A |
|
24 |
24 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
143 |
143 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$937.92 |
| 99173 |
|
34 |
34 |
$755.48 |
| 0071A |
|
12 |
12 |
$540.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
43 |
43 |
$507.83 |
| 36416 |
|
37 |
37 |
$370.00 |
| 99051 |
|
17 |
16 |
$281.52 |
| 87081 |
|
15 |
15 |
$102.60 |
| 94760 |
|
34 |
34 |
$86.02 |
| 81003 |
|
15 |
15 |
$29.70 |