| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,213 |
1,048 |
$24K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
548 |
522 |
$19K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
314 |
303 |
$5K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
287 |
271 |
$5K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
150 |
137 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
185 |
165 |
$5K |
| 99072 |
|
1,250 |
1,102 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
50 |
46 |
$467.14 |
| 92552 |
|
18 |
18 |
$122.97 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
18 |
15 |
$16.71 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,530 |
1,422 |
$6.71 |
| 96127 |
|
326 |
314 |
$5.26 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
245 |
234 |
$0.00 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
13 |
12 |
$0.00 |