| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
560 |
532 |
$32K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
231 |
167 |
$8K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
411 |
410 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
111 |
105 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
12 |
12 |
$1K |
| 96127 |
|
49 |
49 |
$626.47 |
| 0072A |
|
12 |
12 |
$550.56 |
| 99173 |
|
17 |
17 |
$377.74 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
14 |
14 |
$286.30 |
| 94760 |
|
12 |
12 |
$30.36 |