| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
79 |
74 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
73 |
70 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
27 |
27 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
50 |
50 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
64 |
64 |
$712.54 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
66 |
66 |
$595.56 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
43 |
43 |
$552.08 |
| 87081 |
|
28 |
28 |
$205.20 |
| 92551 |
|
14 |
14 |
$150.52 |