| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
86 |
84 |
$6K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
52 |
49 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
29 |
29 |
$1K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
35 |
35 |
$334.56 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
29 |
29 |
$321.98 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
22 |
22 |
$277.52 |
| 87081 |
|
18 |
18 |
$131.67 |