| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
109 |
104 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
86 |
86 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
139 |
122 |
$4K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
271 |
270 |
$2K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
78 |
77 |
$2K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
14 |
14 |
$2K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
12 |
12 |
$2K |
| 96127 |
|
48 |
48 |
$492.96 |
| 99051 |
|
13 |
13 |
$215.28 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17 |
16 |
$174.59 |