| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
384 |
374 |
$22K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
74 |
69 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
29 |
25 |
$2K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
78 |
77 |
$744.12 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
33 |
33 |
$586.85 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
12 |
12 |
$318.60 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
24 |
24 |
$236.21 |
| 90686 |
|
134 |
134 |
$38.61 |