| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,106 |
1,017 |
$65K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
769 |
642 |
$23K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
48 |
48 |
$5K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
533 |
522 |
$5K |
| 96127 |
|
171 |
161 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
58 |
29 |
$691.01 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
47 |
47 |
$482.69 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12 |
12 |
$141.72 |