| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
195 |
158 |
$21K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
176 |
140 |
$5K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
59 |
57 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
114 |
113 |
$2K |
| 92587 |
|
52 |
51 |
$1K |
| 99283 |
Emergency department visit for the evaluation and management, moderate severity |
15 |
15 |
$701.40 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
76 |
71 |
$687.80 |
| 99173 |
|
13 |
13 |
$288.86 |