| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
124 |
122 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
101 |
101 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
56 |
56 |
$2K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
112 |
112 |
$1K |
| 0072A |
|
18 |
18 |
$825.84 |
| 96127 |
|
14 |
14 |
$164.32 |