| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,654 |
3,104 |
$52K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
608 |
588 |
$21K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,631 |
3,462 |
$10K |
| 99441 |
|
483 |
427 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
197 |
193 |
$4K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
205 |
202 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,644 |
2,895 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
57 |
52 |
$1K |
| 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) |
260 |
240 |
$1K |
| 99072 |
|
492 |
403 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
58 |
57 |
$981.63 |
| 90461 |
|
325 |
264 |
$884.68 |
| 90480 |
|
51 |
41 |
$771.52 |
| 92551 |
|
785 |
761 |
$568.70 |
| 0071A |
|
14 |
14 |
$520.00 |
| 0072A |
|
12 |
12 |
$461.79 |
| 98966 |
|
88 |
80 |
$353.74 |
| 99173 |
|
467 |
451 |
$115.58 |
| 90686 |
|
1,032 |
750 |
$39.20 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
21 |
13 |
$33.16 |
| 90656 |
|
112 |
85 |
$0.00 |
| 91307 |
|
100 |
87 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
28 |
27 |
$0.00 |