| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
402 |
394 |
$21K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
81 |
76 |
$8K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
259 |
258 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
66 |
60 |
$2K |
| 96127 |
|
83 |
83 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
39 |
39 |
$400.53 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
17 |
17 |
$347.65 |
| 94760 |
|
14 |
13 |
$35.42 |