| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
111 |
96 |
$8K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
191 |
181 |
$6K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
43 |
41 |
$4K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
43 |
41 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
128 |
124 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
39 |
39 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
61 |
33 |
$1K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
115 |
114 |
$1K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
13 |
13 |
$242.99 |
| 94760 |
|
35 |
31 |
$60.40 |
| 99173 |
|
24 |
24 |
$0.00 |