| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,266 |
2,176 |
$118K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,267 |
1,219 |
$50K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
305 |
301 |
$3K |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$1K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
14 |
14 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
15 |
15 |
$883.20 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
69 |
69 |
$718.95 |
| 99443 |
|
21 |
21 |
$20.97 |
| 99442 |
|
40 |
39 |
$14.27 |