| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
712 |
648 |
$46K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,384 |
1,361 |
$33K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,139 |
2,002 |
$22K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
736 |
679 |
$20K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,929 |
1,812 |
$17K |
| 99173 |
|
768 |
767 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
233 |
204 |
$9K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
154 |
154 |
$7K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
223 |
222 |
$5K |
| 99188 |
|
136 |
136 |
$4K |
| 92552 |
|
133 |
133 |
$3K |
| 0072A |
|
12 |
12 |
$550.56 |
| 90658 |
|
32 |
32 |
$0.00 |
| 90700 |
|
15 |
14 |
$0.00 |
| 90648 |
|
27 |
27 |
$0.00 |
| 90670 |
|
30 |
29 |
$0.00 |