| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
78 |
71 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
116 |
111 |
$7K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
91 |
90 |
$3K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
47 |
47 |
$3K |
| 99173 |
|
61 |
61 |
$1K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
16 |
16 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
100 |
100 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
28 |
28 |
$840.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
88 |
88 |
$796.40 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
18 |
18 |
$307.08 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
13 |
13 |
$189.80 |