| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,895 |
3,698 |
$257K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,571 |
2,395 |
$248K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
401 |
401 |
$70K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
514 |
514 |
$51K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,150 |
1,110 |
$32K |
| S3005 |
Performance measurement, evaluation of patient self assessment, depression |
441 |
441 |
$28K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
309 |
309 |
$27K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,523 |
1,462 |
$17K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
142 |
142 |
$13K |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
472 |
472 |
$12K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
450 |
450 |
$12K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
102 |
102 |
$11K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,069 |
1,006 |
$11K |
| 90682 |
|
173 |
173 |
$11K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
95 |
95 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
412 |
407 |
$9K |
| 90461 |
|
93 |
93 |
$7K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
84 |
68 |
$7K |
| 99173 |
|
210 |
210 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
130 |
127 |
$2K |
| 86403 |
|
128 |
128 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
124 |
61 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
33 |
33 |
$970.97 |
| 87428 |
|
16 |
16 |
$920.00 |
| 90686 |
|
60 |
60 |
$868.80 |
| 87081 |
|
100 |
96 |
$787.00 |
| G0446 |
Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes |
13 |
13 |
$210.00 |
| 96127 |
|
12 |
12 |
$53.40 |
| 81000 |
|
13 |
13 |
$48.88 |