| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
392 |
374 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
422 |
406 |
$4K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
369 |
366 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
231 |
224 |
$3K |
| 92551 |
|
27 |
27 |
$258.34 |
| 99177 |
|
28 |
28 |
$103.56 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
243 |
131 |
$61.35 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
18 |
18 |
$0.00 |
| 90661 |
|
31 |
31 |
$0.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$0.00 |