| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,081 |
1,038 |
$62K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,076 |
844 |
$39K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
303 |
281 |
$29K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
131 |
131 |
$11K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,166 |
1,156 |
$11K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
800 |
792 |
$8K |
| 90461 |
|
212 |
211 |
$8K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
97 |
93 |
$8K |
| 99177 |
|
39 |
39 |
$977.96 |
| 96127 |
|
87 |
84 |
$914.03 |
| 36416 |
|
28 |
28 |
$299.88 |
| 99000 |
|
85 |
83 |
$85.00 |
| 85018 |
|
38 |
38 |
$82.08 |
| 94760 |
|
17 |
16 |
$33.66 |