| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
294 |
283 |
$23K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
326 |
312 |
$19K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
43 |
43 |
$2K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
19 |
19 |
$2K |
| 99215 |
Prolong outpt/office vis |
14 |
13 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
19 |
19 |
$2K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
152 |
152 |
$2K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
170 |
170 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$2K |
| G0108 |
Diabetes outpatient self-management training services, individual, per 30 minutes |
23 |
19 |
$1K |
| 93010 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only |
101 |
85 |
$724.83 |
| 20610 |
|
12 |
12 |
$564.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
15 |
15 |
$525.55 |
| 93000 |
|
18 |
18 |
$241.15 |