| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
353 |
339 |
$21K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
499 |
457 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
130 |
128 |
$12K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
778 |
776 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
218 |
218 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
166 |
166 |
$2K |
| 99050 |
|
54 |
54 |
$894.24 |
| 96127 |
|
71 |
68 |
$729.17 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15 |
15 |
$177.15 |
| 87081 |
|
12 |
12 |
$82.08 |
| 94760 |
|
12 |
12 |
$30.36 |