| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1015 |
Clinic visit/encounter, all-inclusive |
794 |
765 |
$113K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
250 |
250 |
$0.00 |
| 96127 |
|
12 |
12 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
133 |
133 |
$0.00 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13 |
12 |
$0.00 |
| 99173 |
|
61 |
61 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
38 |
38 |
$0.00 |
| 92552 |
|
19 |
19 |
$0.00 |