| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 96127 |
|
504 |
503 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
463 |
455 |
$4K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
430 |
430 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
283 |
260 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
32 |
32 |
$666.72 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
192 |
191 |
$60.45 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
166 |
166 |
$59.30 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
161 |
161 |
$0.00 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
63 |
63 |
$0.00 |