| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
56 |
56 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
42 |
39 |
$2K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
14 |
14 |
$1K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
104 |
104 |
$941.20 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
43 |
43 |
$534.04 |