| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,594 |
1,493 |
$68K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
950 |
929 |
$34K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,971 |
10,422 |
$23K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,952 |
1,940 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,714 |
1,692 |
$6K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,768 |
1,636 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,843 |
1,829 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
188 |
182 |
$944.67 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
873 |
858 |
$691.60 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
16 |
15 |
$209.96 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,734 |
2,606 |
$0.00 |
| G9459 |
Currently a tobacco non-user |
2,608 |
2,583 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
2,377 |
2,347 |
$0.00 |
| 96127 |
|
173 |
172 |
$0.00 |
| 99000 |
|
29 |
29 |
$0.00 |
| 97802 |
|
80 |
80 |
$0.00 |
| 86580 |
|
30 |
29 |
$0.00 |
| S9999 |
Sales tax |
494 |
385 |
$0.00 |
| 90791 |
Psychiatric diagnostic evaluation |
93 |
93 |
$0.00 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
13 |
$0.00 |