| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,385 |
1,378 |
$50K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,678 |
2,509 |
$34K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,238 |
7,666 |
$24K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,221 |
2,197 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
977 |
968 |
$3K |
| 92552 |
|
2,364 |
2,340 |
$1K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,098 |
1,085 |
$1K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
12 |
12 |
$730.74 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
167 |
164 |
$488.57 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
730 |
719 |
$277.78 |
| 99072 |
|
6,584 |
5,936 |
$255.76 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
200 |
198 |
$225.50 |
| G2012 |
Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion |
151 |
150 |
$104.72 |
| 99177 |
|
599 |
568 |
$99.15 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
12 |
$93.01 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
86 |
42 |
$61.30 |
| 96127 |
|
456 |
453 |
$41.83 |
| 99173 |
|
2,032 |
2,013 |
$38.56 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
27 |
27 |
$24.13 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
32 |
32 |
$9.29 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
559 |
546 |
$0.00 |
| G9459 |
Currently a tobacco non-user |
15 |
15 |
$0.00 |