| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
635 |
584 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
917 |
844 |
$12K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
340 |
327 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
418 |
409 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
243 |
237 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
161 |
142 |
$4K |
| 99072 |
|
2,419 |
2,019 |
$3K |
| 90480 |
|
87 |
84 |
$2K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
216 |
213 |
$887.33 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
112 |
110 |
$839.36 |
| 99401 |
|
415 |
391 |
$630.09 |
| 0124A |
|
15 |
15 |
$606.48 |
| 0071A |
|
14 |
14 |
$436.80 |
| 0072A |
|
14 |
14 |
$375.65 |
| 90686 |
|
625 |
570 |
$225.08 |
| 90707 |
|
12 |
12 |
$76.19 |
| 90688 |
|
243 |
238 |
$53.52 |
| 99173 |
|
483 |
465 |
$31.80 |
| 90656 |
|
57 |
57 |
$22.20 |
| 90687 |
|
30 |
29 |
$9.40 |
| 96127 |
|
42 |
42 |
$5.26 |
| 81002 |
|
14 |
12 |
$3.48 |
| 91307 |
|
81 |
58 |
$0.01 |
| 90670 |
|
26 |
24 |
$0.00 |
| 90685 |
|
31 |
29 |
$0.00 |
| 90672 |
|
41 |
40 |
$0.00 |
| 90633 |
|
14 |
14 |
$0.00 |
| 91308 |
|
28 |
25 |
$0.00 |
| 91312 |
|
15 |
15 |
$0.00 |
| 90660 |
|
42 |
42 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
12 |
12 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
26 |
19 |
$0.00 |
| 1036F |
|
12 |
12 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
67 |
67 |
$0.00 |