| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,112 |
1,023 |
$129K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
208 |
198 |
$3K |
| T1002 |
Rn services, up to 15 minutes |
146 |
25 |
$2K |
| 36416 |
|
84 |
77 |
$551.38 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
21 |
13 |
$278.82 |
| 90686 |
|
78 |
73 |
$184.12 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
17 |
12 |
$123.72 |
| 85018 |
|
44 |
39 |
$114.27 |