| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,625 |
2,334 |
$233K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,161 |
1,909 |
$120K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
2,667 |
2,370 |
$46K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
640 |
567 |
$43K |
| 99215 |
Prolong outpt/office vis |
303 |
284 |
$36K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
422 |
389 |
$28K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
378 |
339 |
$23K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,106 |
991 |
$18K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
338 |
306 |
$14K |
| 99188 |
|
916 |
817 |
$11K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,415 |
1,219 |
$9K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
276 |
250 |
$9K |
| X5622 |
|
56 |
42 |
$9K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
414 |
357 |
$6K |
| 90461 |
|
274 |
253 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
68 |
65 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
54 |
54 |
$4K |
| 92551 |
|
523 |
500 |
$4K |
| 96127 |
|
1,041 |
936 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
407 |
389 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
98 |
96 |
$2K |
| 99173 |
|
640 |
596 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
67 |
62 |
$1K |
| 90473 |
|
63 |
56 |
$931.41 |
| 99383 |
|
12 |
12 |
$921.22 |
| 96161 |
|
497 |
439 |
$486.78 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
13 |
12 |
$457.36 |
| 90677 |
|
116 |
113 |
$302.20 |
| 85018 |
|
109 |
109 |
$255.85 |
| 90686 |
|
254 |
228 |
$193.29 |
| 90474 |
|
16 |
12 |
$122.33 |
| 36416 |
|
15 |
14 |
$39.82 |
| 90656 |
|
55 |
55 |
$22.75 |
| 91307 |
|
13 |
12 |
$0.78 |
| 90672 |
|
76 |
69 |
$0.15 |
| 90670 |
|
83 |
77 |
$0.08 |
| 90651 |
|
28 |
28 |
$0.01 |
| 90697 |
|
15 |
15 |
$0.01 |
| 90633 |
|
59 |
58 |
$0.01 |
| 90660 |
|
26 |
26 |
$0.00 |
| 99072 |
|
528 |
403 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |
| 90661 |
|
14 |
14 |
$0.00 |