| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
700 |
662 |
$68K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
389 |
384 |
$19K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
295 |
275 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
63 |
63 |
$2K |
| 87428 |
|
38 |
38 |
$2K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
230 |
230 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
60 |
44 |
$866.24 |
| 96127 |
|
61 |
57 |
$684.45 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
30 |
30 |
$613.50 |
| 99173 |
|
30 |
30 |
$569.79 |
| 92551 |
|
46 |
46 |
$395.25 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
13 |
$196.83 |