| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
325 |
319 |
$20K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
407 |
399 |
$16K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
349 |
349 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
40 |
40 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
29 |
29 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
165 |
165 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
25 |
25 |
$1K |