| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,044 |
1,014 |
$36K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,683 |
3,238 |
$15K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,725 |
2,441 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
823 |
807 |
$4K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
639 |
566 |
$4K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
229 |
216 |
$2K |
| 87428 |
|
26 |
25 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
329 |
322 |
$1K |
| 99072 |
|
4,876 |
4,296 |
$748.74 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
466 |
460 |
$281.60 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
111 |
109 |
$249.06 |
| 92551 |
|
893 |
881 |
$134.28 |
| 90688 |
|
500 |
487 |
$64.63 |
| 99173 |
|
900 |
889 |
$37.57 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
14 |
13 |
$16.58 |
| 90461 |
|
15 |
14 |
$8.00 |
| 96127 |
|
30 |
27 |
$3.62 |
| 90656 |
|
123 |
123 |
$0.00 |
| 90686 |
|
284 |
278 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
114 |
113 |
$0.00 |
| 90698 |
|
199 |
191 |
$0.00 |
| 90677 |
|
31 |
30 |
$0.00 |
| 90680 |
|
52 |
51 |
$0.00 |
| 90716 |
|
13 |
12 |
$0.00 |
| 90697 |
|
13 |
13 |
$0.00 |
| 90670 |
|
210 |
201 |
$0.00 |
| 90685 |
|
32 |
31 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
62 |
29 |
$0.00 |
| 90687 |
|
37 |
36 |
$0.00 |
| 90633 |
|
12 |
12 |
$0.00 |
| G2252 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 11-20 minutes of medical discussion |
14 |
13 |
$0.00 |
| 90707 |
|
13 |
13 |
$0.00 |