| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
204 |
200 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
253 |
252 |
$8K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
92 |
92 |
$1K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
101 |
101 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
12 |
12 |
$198.60 |
| 92551 |
|
17 |
17 |
$185.64 |