| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
154 |
142 |
$11K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
32 |
32 |
$3K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
31 |
31 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
64 |
63 |
$1K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
81 |
81 |
$866.70 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
43 |
43 |
$695.07 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
82 |
82 |
$625.20 |
| 90686 |
|
14 |
14 |
$0.00 |
| 90651 |
|
12 |
12 |
$0.00 |