| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
241 |
228 |
$14K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
66 |
65 |
$6K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
52 |
52 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
132 |
75 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
25 |
25 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16 |
16 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
86 |
86 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
91 |
91 |
$985.92 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$936.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
87 |
87 |
$787.35 |