| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
964 |
936 |
$26K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
644 |
642 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
155 |
154 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
102 |
99 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
583 |
288 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
114 |
112 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
136 |
136 |
$1K |
| 96127 |
|
93 |
92 |
$944.84 |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
45 |
44 |
$293.85 |
| 90686 |
|
46 |
46 |
$19.58 |
| 90734 |
|
16 |
16 |
$0.00 |
| 90680 |
|
26 |
26 |
$0.00 |
| 90677 |
|
28 |
27 |
$0.00 |
| 90698 |
|
26 |
26 |
$0.00 |
| 90656 |
|
25 |
25 |
$0.00 |