| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,913 |
2,621 |
$181K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,628 |
1,604 |
$44K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
276 |
264 |
$24K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,966 |
1,956 |
$20K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,961 |
1,948 |
$19K |
| 99173 |
|
810 |
808 |
$18K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
96 |
96 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
87 |
87 |
$8K |
| 81002 |
|
624 |
620 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
106 |
68 |
$1K |
| 0071A |
|
17 |
17 |
$779.79 |
| 0072A |
|
13 |
13 |
$596.31 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
13 |
13 |
$353.30 |
| 90461 |
|
40 |
39 |
$295.20 |
| 90686 |
|
862 |
855 |
$251.28 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$141.72 |
| 86403 |
|
12 |
12 |
$126.12 |
| 94760 |
|
82 |
69 |
$78.43 |
| 91307 |
|
39 |
39 |
$0.00 |