| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,536 |
3,141 |
$213K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
262 |
257 |
$23K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
221 |
221 |
$18K |
| 92551 |
|
1,156 |
1,155 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
158 |
158 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
492 |
481 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
130 |
124 |
$11K |
| 99401 |
|
258 |
257 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
733 |
707 |
$5K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
346 |
345 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
44 |
44 |
$4K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
37 |
37 |
$3K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,090 |
1,062 |
$3K |
| 90461 |
|
203 |
195 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
373 |
370 |
$667.10 |
| 99173 |
|
235 |
234 |
$396.12 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
12 |
12 |
$89.51 |
| 90656 |
|
53 |
53 |
$15.82 |
| 3008F |
|
482 |
480 |
$2.00 |
| 4124F |
|
1,370 |
1,302 |
$0.00 |
| G8482 |
Influenza immunization administered or previously received |
310 |
308 |
$0.00 |
| 90648 |
|
14 |
14 |
$0.00 |
| 90670 |
|
53 |
53 |
$0.00 |
| 3078F |
|
57 |
57 |
$0.00 |
| 90685 |
|
13 |
13 |
$0.00 |
| 2000F |
|
35 |
35 |
$0.00 |
| 2010F |
|
1,957 |
1,764 |
$0.00 |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
12 |
12 |
$0.00 |
| 2001F |
|
2,068 |
1,855 |
$0.00 |
| 2030F |
|
44 |
43 |
$0.00 |
| 3351F |
|
56 |
56 |
$0.00 |
| 90680 |
|
13 |
13 |
$0.00 |
| 4058F |
|
46 |
45 |
$0.00 |
| 4056F |
|
47 |
46 |
$0.00 |
| 1220F |
|
57 |
57 |
$0.00 |
| 1036F |
|
15 |
15 |
$0.00 |
| 1000F |
|
56 |
56 |
$0.00 |
| 1126F |
|
18 |
18 |
$0.00 |
| 90657 |
|
12 |
12 |
$0.00 |
| 90698 |
|
13 |
13 |
$0.00 |