| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
5,304 |
4,786 |
$143K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,701 |
1,565 |
$11K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
116 |
107 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
136 |
133 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
53 |
51 |
$2K |
| 99072 |
|
296 |
275 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
13 |
$713.80 |
| 97802 |
|
2,046 |
1,917 |
$148.52 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
40 |
29 |
$45.13 |
| 90688 |
|
173 |
164 |
$17.84 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
2,035 |
1,906 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
345 |
332 |
$0.00 |
| 96127 |
|
80 |
80 |
$0.00 |
| 1036F |
|
15 |
15 |
$0.00 |
| G9459 |
Currently a tobacco non-user |
28 |
26 |
$0.00 |
| 90651 |
|
27 |
26 |
$0.00 |
| 4037F |
|
20 |
20 |
$0.00 |
| 90670 |
|
14 |
12 |
$0.00 |
| 90687 |
|
15 |
15 |
$0.00 |
| S9999 |
Sales tax |
33 |
26 |
$0.00 |