| Code | Description | Claims | Beneficiaries | Total Paid |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
469 |
448 |
$28K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
179 |
152 |
$5K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
326 |
326 |
$3K |
| 96127 |
|
106 |
106 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
49 |
49 |
$1K |