| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
695 |
667 |
$40K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
210 |
201 |
$24K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
414 |
335 |
$16K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
700 |
669 |
$8K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
808 |
807 |
$7K |
| 87428 |
|
103 |
99 |
$6K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
181 |
181 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
67 |
34 |
$825.35 |
| 92551 |
|
85 |
85 |
$739.51 |
| 90461 |
|
12 |
12 |
$447.48 |
| 96127 |
|
29 |
26 |
$293.75 |
| 99173 |
|
12 |
12 |
$246.59 |