| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,021 |
3,321 |
$230K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,052 |
1,751 |
$202K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,572 |
1,417 |
$44K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,487 |
1,474 |
$14K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
550 |
510 |
$13K |
| 99051 |
|
626 |
573 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
105 |
105 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
822 |
765 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
95 |
95 |
$8K |
| 99173 |
|
351 |
350 |
$8K |
| 99401 |
|
194 |
191 |
$6K |
| 96127 |
|
515 |
515 |
$5K |
| 0071A |
|
91 |
91 |
$4K |
| 0072A |
|
81 |
81 |
$4K |
| 92552 |
|
105 |
105 |
$3K |
| 0074A |
|
57 |
57 |
$3K |
| 90461 |
|
65 |
65 |
$2K |
| 99188 |
|
75 |
74 |
$2K |
| 36416 |
|
191 |
191 |
$2K |
| 99442 |
|
88 |
80 |
$2K |
| 0082A |
|
35 |
35 |
$2K |
| 0083A |
|
33 |
33 |
$2K |
| 0124A |
|
25 |
25 |
$1K |
| 0081A |
|
23 |
23 |
$1K |
| 0002A |
|
23 |
23 |
$1K |
| 0004A |
|
18 |
18 |
$825.84 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
60 |
59 |
$800.16 |
| 0054A |
|
12 |
12 |
$750.00 |
| 0001A |
|
15 |
15 |
$688.20 |
| 0154A |
|
12 |
12 |
$550.56 |
| 99177 |
|
12 |
12 |
$450.00 |
| 85018 |
|
188 |
188 |
$423.16 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
15 |
13 |
$305.20 |
| 99000 |
|
242 |
229 |
$242.00 |
| 94664 |
|
12 |
12 |
$172.56 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
14 |
13 |
$115.00 |
| 92551 |
|
12 |
12 |
$101.16 |