| 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) |
276 |
269 |
$11K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
449 |
403 |
$478.39 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
198 |
195 |
$150.00 |
| 99421 |
|
974 |
942 |
$81.35 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
156 |
153 |
$34.35 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
212 |
209 |
$16.53 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
700 |
681 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
311 |
305 |
$0.00 |
| 99173 |
|
12 |
12 |
$0.00 |