| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
341 |
317 |
$19K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
353 |
306 |
$12K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
386 |
383 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
29 |
29 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$1K |
| 90461 |
|
26 |
26 |
$974.16 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
93 |
93 |
$955.11 |
| 99173 |
|
27 |
27 |
$599.94 |
| 96127 |
|
52 |
52 |
$534.04 |