| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,461 |
6,793 |
$473K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
8,185 |
7,749 |
$287K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,908 |
5,447 |
$282K |
| X5622 |
|
3,541 |
3,188 |
$137K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,144 |
6,455 |
$75K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,289 |
1,229 |
$73K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,065 |
1,012 |
$71K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,199 |
1,129 |
$68K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
890 |
835 |
$44K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
2,764 |
2,539 |
$35K |
| 92551 |
|
5,908 |
5,450 |
$30K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,127 |
2,037 |
$29K |
| 96127 |
|
9,918 |
7,092 |
$29K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
463 |
418 |
$18K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
606 |
297 |
$9K |
| 36416 |
|
2,632 |
2,400 |
$8K |
| 87070 |
|
1,032 |
992 |
$8K |
| 99173 |
|
5,827 |
5,351 |
$6K |
| 80061 |
Lipid panel |
421 |
388 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,631 |
1,218 |
$4K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
553 |
508 |
$3K |
| 99188 |
|
877 |
836 |
$3K |
| 90686 |
|
2,178 |
2,043 |
$3K |
| 85018 |
|
993 |
925 |
$2K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
332 |
156 |
$1K |
| 99441 |
|
43 |
41 |
$1K |
| 90670 |
|
321 |
287 |
$887.66 |
| 90651 |
|
278 |
255 |
$747.26 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
81 |
80 |
$640.81 |
| 90480 |
|
18 |
18 |
$593.17 |
| 96161 |
|
330 |
295 |
$403.72 |
| 90734 |
|
209 |
198 |
$282.43 |
| 87807 |
|
13 |
13 |
$164.85 |
| 90474 |
|
15 |
14 |
$102.29 |
| 90647 |
|
114 |
100 |
$52.41 |
| 96160 |
|
2,126 |
2,007 |
$0.00 |
| 90633 |
|
82 |
74 |
$0.00 |
| 90707 |
|
132 |
114 |
$0.00 |
| 90715 |
|
72 |
71 |
$0.00 |
| 83655 |
|
26 |
25 |
$0.00 |
| 90700 |
|
13 |
12 |
$0.00 |
| 90681 |
|
15 |
14 |
$0.00 |
| 90716 |
|
83 |
71 |
$0.00 |
| 90723 |
|
132 |
119 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |