| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,488 |
7,423 |
$439K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,898 |
4,118 |
$240K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,450 |
1,434 |
$36K |
| 92552 |
|
1,412 |
1,387 |
$20K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
218 |
217 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
179 |
179 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
687 |
655 |
$8K |
| 99497 |
|
107 |
107 |
$5K |
| 36415 |
Collection of venous blood by venipuncture |
1,550 |
1,505 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
599 |
591 |
$3K |
| 99173 |
|
1,393 |
1,370 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
161 |
148 |
$1K |
| 0012A |
|
61 |
61 |
$1K |
| 96127 |
|
190 |
190 |
$841.32 |
| 0011A |
|
57 |
56 |
$825.02 |
| Q2039 |
Influenza virus vaccine, not otherwise specified |
12 |
12 |
$47.06 |
| G0008 |
Administration of influenza virus vaccine |
12 |
12 |
$37.52 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
12 |
12 |
$32.92 |
| 90649 |
|
67 |
67 |
$0.05 |
| 90734 |
|
46 |
44 |
$0.01 |
| 90656 |
|
76 |
76 |
$0.00 |
| 91301 |
|
124 |
118 |
$0.00 |
| X5622 |
|
1,005 |
1,001 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
29 |
29 |
$0.00 |
| 99397 |
|
16 |
12 |
$0.00 |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
14 |
13 |
$0.00 |