| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,125 |
3,053 |
$180K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
829 |
820 |
$78K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,088 |
1,576 |
$66K |
| 92558 |
|
1,157 |
1,157 |
$41K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
376 |
376 |
$31K |
| 99177 |
|
1,366 |
1,365 |
$29K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
550 |
547 |
$28K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
2,204 |
2,204 |
$20K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
236 |
236 |
$20K |
| 96127 |
|
1,172 |
1,154 |
$13K |
| 90461 |
|
378 |
378 |
$12K |
| 99051 |
|
669 |
661 |
$11K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,041 |
901 |
$10K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
125 |
123 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
97 |
97 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
350 |
350 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
172 |
172 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
241 |
236 |
$3K |
| 92587 |
|
151 |
147 |
$2K |
| 0071A |
|
27 |
27 |
$1K |
| 0083A |
|
14 |
14 |
$642.32 |
| 0081A |
|
12 |
12 |
$550.56 |
| 0072A |
|
12 |
12 |
$550.56 |
| 0074A |
|
12 |
12 |
$550.56 |
| 99188 |
|
12 |
12 |
$312.00 |
| 99000 |
|
32 |
30 |
$32.00 |
| 99072 |
|
45 |
45 |
$0.00 |