| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,901 |
1,711 |
$97K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
813 |
793 |
$33K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
109 |
104 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
461 |
445 |
$7K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
127 |
118 |
$3K |
| 92552 |
|
199 |
191 |
$3K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
76 |
75 |
$3K |
| 96127 |
|
359 |
346 |
$1K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
42 |
41 |
$861.98 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
27 |
26 |
$783.90 |
| 90473 |
|
14 |
14 |
$275.34 |
| 99173 |
|
200 |
192 |
$210.41 |
| 90686 |
|
176 |
171 |
$22.24 |
| 96160 |
|
283 |
280 |
$1.68 |
| X5622 |
|
348 |
347 |
$0.00 |
| 90672 |
|
13 |
13 |
$0.00 |