| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,454 |
1,321 |
$11K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
453 |
450 |
$5K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
162 |
155 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
233 |
221 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
424 |
266 |
$905.29 |
| 96127 |
|
72 |
72 |
$757.93 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
12 |
12 |
$254.05 |
| 90661 |
|
33 |
33 |
$0.00 |
| 99173 |
|
12 |
12 |
$0.00 |