| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
375 |
325 |
$34K |
| 99215 |
Prolong outpt/office vis |
54 |
46 |
$6K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
158 |
118 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
220 |
217 |
$2K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
200 |
197 |
$2K |
| 85018 |
|
145 |
145 |
$353.52 |
| 82465 |
|
70 |
70 |
$318.73 |
| 81005 |
|
114 |
112 |
$253.92 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
14 |
$166.68 |
| 87070 |
|
12 |
12 |
$107.56 |
| 90686 |
|
83 |
83 |
$0.00 |