| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
210 |
200 |
$12K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
51 |
51 |
$4K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
51 |
51 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
12 |
12 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
28 |
28 |
$1K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
103 |
103 |
$932.15 |
| 87634 |
|
12 |
12 |
$743.04 |
| 96127 |
|
67 |
67 |
$688.09 |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
14 |
13 |
$433.30 |
| 85018 |
|
17 |
17 |
$35.53 |