| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,698 |
6,497 |
$317K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,658 |
6,449 |
$264K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
2,229 |
2,225 |
$20K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,111 |
1,091 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
256 |
256 |
$10K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
150 |
150 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
161 |
161 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
122 |
120 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
92 |
89 |
$2K |
| 96127 |
|
172 |
172 |
$2K |
| 99442 |
|
417 |
402 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
12 |
12 |
$1K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
28 |
28 |
$1K |
| 99441 |
|
98 |
95 |
$473.88 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
59 |
37 |
$418.90 |
| 11721 |
|
12 |
12 |
$210.00 |
| 86580 |
|
16 |
16 |
$100.38 |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$0.00 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
12 |
12 |
$0.00 |