| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
147 |
137 |
$10K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
70 |
70 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
52 |
51 |
$581.88 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
54 |
54 |
$562.14 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
12 |
12 |
$192.85 |