| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,331 |
1,249 |
$12K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
302 |
295 |
$11K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
713 |
688 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
510 |
504 |
$9K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
164 |
164 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
371 |
362 |
$3K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
162 |
155 |
$3K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
27 |
27 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
91 |
90 |
$568.95 |
| 92551 |
|
1,517 |
1,490 |
$494.44 |
| 99173 |
|
1,635 |
1,605 |
$337.04 |
| 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) |
122 |
119 |
$243.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
67 |
66 |
$205.30 |
| 96127 |
|
849 |
828 |
$127.24 |
| 90686 |
|
342 |
338 |
$27.36 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,716 |
1,487 |
$26.44 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
292 |
285 |
$0.00 |
| 90688 |
|
23 |
23 |
$0.00 |
| 90461 |
|
13 |
13 |
$0.00 |