| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
668 |
634 |
$42K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
164 |
162 |
$16K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
145 |
145 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
273 |
269 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
71 |
71 |
$1K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
58 |
58 |
$569.49 |
| 90686 |
|
15 |
15 |
$278.87 |
| 96127 |
|
266 |
265 |
$41.08 |