| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,130 |
1,063 |
$18K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
324 |
315 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
173 |
169 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
759 |
684 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
292 |
291 |
$5K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
222 |
217 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
125 |
117 |
$2K |
| 99382 |
|
17 |
15 |
$2K |
| 99383 |
|
53 |
52 |
$2K |
| 99384 |
|
67 |
67 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
86 |
83 |
$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) |
238 |
214 |
$559.92 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
12 |
12 |
$481.98 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
132 |
128 |
$395.96 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
57 |
57 |
$312.68 |
| 92551 |
|
697 |
676 |
$241.43 |
| 99173 |
|
710 |
688 |
$156.08 |
| 96127 |
|
553 |
538 |
$98.37 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
882 |
765 |
$9.59 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
291 |
279 |
$0.00 |
| 90656 |
|
37 |
37 |
$0.00 |
| 90619 |
|
27 |
27 |
$0.00 |
| 90686 |
|
26 |
24 |
$0.00 |
| 90651 |
|
29 |
29 |
$0.00 |
| 90715 |
|
14 |
14 |
$0.00 |
| 90707 |
|
20 |
20 |
$0.00 |