| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
250 |
226 |
$22K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
200 |
134 |
$7K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
112 |
107 |
$7K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
154 |
149 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
21 |
17 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
145 |
142 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
42 |
39 |
$581.73 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
12 |
12 |
$209.72 |
| 81002 |
|
13 |
12 |
$43.35 |
| 90686 |
|
13 |
13 |
$19.03 |