| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,971 |
2,852 |
$105K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
476 |
459 |
$28K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
593 |
593 |
$27K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
2,869 |
2,865 |
$26K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,129 |
2,128 |
$22K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
410 |
410 |
$21K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
267 |
267 |
$15K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
271 |
254 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
13 |
13 |
$897.39 |
| 99401 |
|
42 |
42 |
$789.18 |