| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,789 |
2,717 |
$160K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,486 |
1,147 |
$49K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
412 |
403 |
$37K |
| 92558 |
|
900 |
900 |
$36K |
| 99177 |
|
1,007 |
1,007 |
$25K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
487 |
484 |
$25K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
221 |
221 |
$18K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,716 |
1,714 |
$16K |
| 99051 |
|
844 |
832 |
$14K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
130 |
130 |
$12K |
| 96127 |
|
966 |
961 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
117 |
117 |
$10K |
| 90461 |
|
217 |
217 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
644 |
544 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
305 |
305 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
155 |
153 |
$3K |
| 92587 |
|
114 |
112 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
115 |
114 |
$1K |
| 99188 |
|
25 |
25 |
$650.00 |
| 0071A |
|
14 |
14 |
$642.32 |
| 0081A |
|
12 |
12 |
$550.56 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
16 |
16 |
$495.20 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
15 |
$480.91 |
| 92552 |
|
12 |
12 |
$195.72 |
| 99000 |
|
12 |
12 |
$12.00 |
| 99072 |
|
60 |
59 |
$0.00 |