| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
137 |
133 |
$8K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
27 |
25 |
$379.99 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
16 |
16 |
$327.20 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
12 |
12 |
$108.60 |