| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
617 |
511 |
$11K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,531 |
1,116 |
$4K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
102 |
89 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
97 |
79 |
$3K |
| 99441 |
|
119 |
108 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
52 |
31 |
$2K |
| 99072 |
|
47 |
44 |
$758.40 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
12 |
$600.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
714 |
466 |
$157.72 |
| 90461 |
|
144 |
108 |
$115.14 |
| 92551 |
|
133 |
120 |
$69.78 |
| 99173 |
|
238 |
202 |
$20.32 |
| 90661 |
|
56 |
56 |
$0.05 |
| 90674 |
|
75 |
72 |
$0.00 |