| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,847 |
2,617 |
$43K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,907 |
1,770 |
$35K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
376 |
328 |
$14K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
345 |
337 |
$12K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
198 |
194 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,685 |
1,604 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
233 |
227 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
113 |
110 |
$2K |
| 90461 |
|
343 |
338 |
$712.74 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,628 |
1,585 |
$287.72 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
262 |
128 |
$248.70 |
| 96127 |
|
342 |
332 |
$112.09 |
| 90686 |
|
606 |
579 |
$62.74 |
| 92552 |
|
134 |
129 |
$60.37 |
| 99173 |
|
131 |
129 |
$7.66 |
| 90688 |
|
126 |
125 |
$0.00 |
| 90680 |
|
54 |
54 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
28 |
28 |
$0.00 |
| 90651 |
|
44 |
43 |
$0.00 |
| 90677 |
|
13 |
12 |
$0.00 |
| 90698 |
|
54 |
54 |
$0.00 |
| 90707 |
|
150 |
148 |
$0.00 |
| 90670 |
|
158 |
148 |
$0.00 |
| 90685 |
|
57 |
57 |
$0.00 |