| 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) |
973 |
972 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
267 |
267 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
257 |
255 |
$726.17 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
83 |
83 |
$581.40 |
| 99188 |
|
14 |
14 |
$392.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
171 |
170 |
$326.40 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
65 |
65 |
$118.60 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
41 |
41 |
$59.30 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
64 |
64 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
46 |
45 |
$0.00 |