| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
369 |
327 |
$23K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
234 |
211 |
$17K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
204 |
191 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
39 |
28 |
$2K |
| 99383 |
|
20 |
18 |
$1K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15 |
15 |
$1K |
| 99382 |
|
13 |
12 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
12 |
12 |
$795.85 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
128 |
117 |
$793.39 |
| 90461 |
|
67 |
42 |
$489.39 |
| 92551 |
|
52 |
49 |
$346.09 |
| 99188 |
|
24 |
24 |
$216.10 |
| 99173 |
|
68 |
61 |
$101.38 |
| 90473 |
|
17 |
13 |
$59.88 |
| 90672 |
|
27 |
22 |
$51.33 |