| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
547 |
479 |
$7K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
114 |
101 |
$4K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
335 |
304 |
$3K |
| 99072 |
|
1,146 |
1,005 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
475 |
401 |
$2K |
| 99441 |
|
155 |
133 |
$589.54 |
| 90480 |
|
20 |
20 |
$588.32 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
12 |
12 |
$113.80 |
| 99442 |
|
13 |
13 |
$96.87 |
| 92551 |
|
341 |
329 |
$73.88 |
| 99173 |
|
391 |
375 |
$4.13 |
| 96160 |
|
13 |
12 |
$2.18 |