| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
581 |
547 |
$36K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
184 |
175 |
$15K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
533 |
226 |
$11K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
208 |
205 |
$6K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
349 |
348 |
$3K |
| 96127 |
|
124 |
124 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$994.32 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
35 |
35 |
$813.11 |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
13 |
13 |
$753.61 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
65 |
65 |
$667.55 |
| 90461 |
|
13 |
13 |
$472.32 |