| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
614 |
586 |
$35K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
592 |
533 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
88 |
85 |
$10K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
578 |
578 |
$5K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
19 |
17 |
$3K |
| 96127 |
|
158 |
158 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
102 |
101 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$994.32 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
44 |
37 |
$862.22 |
| 0072A |
|
12 |
12 |
$550.56 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
26 |
25 |
$317.46 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
15 |
12 |
$164.25 |