| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,846 |
1,759 |
$123K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,739 |
1,681 |
$83K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
508 |
506 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
66 |
60 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
233 |
232 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
38 |
38 |
$2K |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$937.89 |