| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,516 |
5,136 |
$342K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,221 |
6,078 |
$322K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,476 |
1,473 |
$13K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
219 |
219 |
$13K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
175 |
168 |
$10K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
909 |
908 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
146 |
146 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
93 |
93 |
$6K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
181 |
177 |
$4K |
| 99215 |
Prolong outpt/office vis |
67 |
67 |
$3K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$897.00 |
| 99443 |
|
46 |
41 |
$49.34 |
| 99442 |
|
77 |
68 |
$21.15 |