| 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) |
208 |
203 |
$8K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
531 |
491 |
$1K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
662 |
579 |
$399.41 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
24 |
24 |
$120.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
26 |
26 |
$114.82 |
| 99072 |
|
1,192 |
1,026 |
$32.66 |
| 94760 |
|
345 |
318 |
$16.03 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
39 |
38 |
$0.00 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
16 |
14 |
$0.00 |
| 96160 |
|
25 |
25 |
$0.00 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
16 |
12 |
$0.00 |
| 99173 |
|
14 |
12 |
$0.00 |
| 92551 |
|
14 |
12 |
$0.00 |
| 96127 |
|
37 |
37 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
24 |
24 |
$0.00 |