| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,220 |
1,164 |
$63K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
609 |
468 |
$17K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
164 |
157 |
$16K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,028 |
1,021 |
$9K |
| 99050 |
|
391 |
384 |
$6K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
458 |
453 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
37 |
37 |
$3K |
| 96127 |
|
254 |
254 |
$3K |
| 36416 |
|
257 |
254 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
173 |
173 |
$2K |
| 80061 |
Lipid panel |
28 |
27 |
$341.88 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
27 |
27 |
$330.21 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
14 |
$170.94 |
| 92551 |
|
13 |
13 |
$109.59 |
| 81002 |
|
27 |
27 |
$70.30 |
| 82962 |
|
25 |
25 |
$60.50 |