| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,747 |
7,945 |
$137K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,646 |
2,018 |
$68K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,847 |
1,263 |
$52K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,370 |
1,872 |
$34K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,080 |
978 |
$28K |
| 99383 |
|
255 |
235 |
$16K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,552 |
1,175 |
$11K |
| 99382 |
|
119 |
111 |
$9K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
302 |
249 |
$9K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,580 |
1,365 |
$8K |
| 99381 |
|
92 |
79 |
$5K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
103 |
103 |
$5K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
405 |
332 |
$4K |
| 92552 |
|
1,637 |
1,374 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,572 |
2,285 |
$3K |
| 96127 |
|
7,294 |
5,242 |
$2K |
| 90461 |
|
248 |
196 |
$879.40 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
12 |
12 |
$864.70 |
| 99384 |
|
16 |
14 |
$828.51 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
82 |
73 |
$813.35 |
| 90671 |
|
226 |
131 |
$760.68 |
| 86580 |
|
76 |
72 |
$471.14 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
39 |
38 |
$183.37 |
| 99173 |
|
1,770 |
1,487 |
$139.07 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
32 |
31 |
$103.07 |
| 90723 |
|
369 |
287 |
$85.00 |
| 90686 |
|
1,773 |
1,402 |
$66.74 |
| 96161 |
|
1,648 |
1,080 |
$55.37 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
33 |
27 |
$54.57 |
| 90698 |
|
218 |
140 |
$48.00 |
| 90680 |
|
472 |
343 |
$8.00 |
| 90744 |
|
91 |
57 |
$4.00 |
| 90670 |
|
1,094 |
811 |
$4.00 |
| 90633 |
|
723 |
578 |
$4.00 |
| 96160 |
|
48 |
34 |
$3.11 |
| 90651 |
|
161 |
121 |
$0.00 |
| 90688 |
|
693 |
604 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
962 |
685 |
$0.00 |
| G9275 |
Documentation that patient is a current non-tobacco user |
696 |
494 |
$0.00 |
| 90716 |
|
166 |
134 |
$0.00 |
| G9459 |
Currently a tobacco non-user |
241 |
200 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
101 |
92 |
$0.00 |
| 90696 |
|
48 |
39 |
$0.00 |
| 90734 |
|
220 |
168 |
$0.00 |
| 90707 |
|
288 |
232 |
$0.00 |
| 90648 |
|
720 |
565 |
$0.00 |
| 90700 |
|
66 |
52 |
$0.00 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
24 |
13 |
$0.00 |
| S9999 |
Sales tax |
53 |
44 |
$0.00 |
| 90710 |
|
30 |
29 |
$0.00 |
| 90687 |
|
273 |
227 |
$0.00 |
| 90649 |
|
38 |
38 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |