| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,558 |
1,467 |
$85K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
234 |
222 |
$20K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
310 |
241 |
$10K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
943 |
941 |
$9K |
| 96127 |
|
457 |
452 |
$5K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
105 |
103 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
165 |
164 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
69 |
69 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$1K |
| 90461 |
|
12 |
12 |
$393.60 |
| 99173 |
|
14 |
14 |
$311.08 |
| 94760 |
|
35 |
32 |
$69.30 |
| 99000 |
|
13 |
13 |
$13.00 |