| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
173 |
156 |
$10K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
42 |
42 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
37 |
37 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
244 |
240 |
$1K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
276 |
272 |
$1K |
| 96127 |
|
27 |
26 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
101 |
101 |
$0.00 |
| 90461 |
|
31 |
31 |
$0.00 |