| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
156 |
153 |
$10K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
51 |
48 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
87 |
87 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
14 |
$2K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
150 |
150 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
13 |
13 |
$850.62 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
57 |
57 |
$620.61 |
| 0071A |
|
12 |
12 |
$605.64 |
| 99173 |
|
25 |
25 |
$600.00 |
| 96127 |
|
76 |
75 |
$323.76 |