| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,670 |
3,403 |
$36K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
2,400 |
2,384 |
$20K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,319 |
1,316 |
$14K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
267 |
263 |
$13K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
127 |
126 |
$10K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,282 |
1,750 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
661 |
621 |
$6K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
149 |
147 |
$4K |
| 92551 |
|
368 |
365 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
231 |
231 |
$3K |
| 99050 |
|
448 |
437 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
406 |
402 |
$2K |
| 90480 |
|
31 |
28 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
49 |
47 |
$465.73 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
26 |
$307.01 |
| 90461 |
|
27 |
27 |
$282.10 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
195 |
195 |
$272.67 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
14 |
12 |
$100.24 |
| 90656 |
|
275 |
273 |
$88.45 |
| 85018 |
|
38 |
38 |
$77.33 |
| 99174 |
|
12 |
12 |
$65.00 |
| 99072 |
|
80 |
68 |
$0.00 |
| 91321 |
|
12 |
12 |
$0.00 |
| 99173 |
|
128 |
126 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
126 |
126 |
$0.00 |
| 90686 |
|
123 |
123 |
$0.00 |
| 36416 |
|
13 |
12 |
$0.00 |
| 90677 |
|
52 |
52 |
$0.00 |