| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
138 |
138 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
175 |
163 |
$11K |
| 92588 |
|
15 |
15 |
$951.15 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
51 |
51 |
$743.58 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
18 |
18 |
$722.04 |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
12 |
12 |
$496.56 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
44 |
44 |
$477.84 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
38 |
38 |
$443.84 |
| 99173 |
|
13 |
13 |
$346.58 |
| 94760 |
|
13 |
13 |
$23.53 |