| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
125 |
96 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
67 |
53 |
$3K |
| 3008F |
|
146 |
110 |
$440.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
32 |
15 |
$281.14 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
31 |
23 |
$200.33 |
| 96127 |
|
27 |
19 |
$49.01 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
24 |
18 |
$0.00 |