| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
61 |
57 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
81 |
54 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$1K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
58 |
57 |
$609.90 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
46 |
46 |
$520.29 |