| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
228 |
220 |
$13K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
224 |
224 |
$9K |
| 90461 |
|
63 |
63 |
$3K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
54 |
54 |
$3K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
271 |
269 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
173 |
173 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
17 |
17 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
17 |
16 |
$1K |
| 96127 |
|
74 |
74 |
$759.98 |
| 99173 |
|
15 |
15 |
$333.30 |
| 85018 |
|
60 |
60 |
$126.24 |
| 92551 |
|
13 |
13 |
$123.76 |