| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
205 |
201 |
$13K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
143 |
143 |
$4K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
37 |
36 |
$2K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
126 |
126 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
60 |
59 |
$642.00 |
| 96127 |
|
68 |
67 |
$302.44 |
| 99173 |
|
12 |
12 |
$288.00 |