| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
44 |
43 |
$3K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
208 |
206 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
173 |
172 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
13 |
13 |
$844.22 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
16 |
15 |
$813.28 |