| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,248 |
1,918 |
$68K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,317 |
2,087 |
$53K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,183 |
2,905 |
$43K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,838 |
1,687 |
$42K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
889 |
787 |
$29K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,773 |
1,653 |
$29K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
814 |
737 |
$10K |
| 87428 |
|
143 |
135 |
$9K |
| 99460 |
|
139 |
125 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,060 |
1,008 |
$8K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,078 |
2,702 |
$8K |
| 99072 |
|
5,262 |
4,456 |
$8K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
139 |
128 |
$7K |
| 0071A |
|
50 |
47 |
$2K |
| 0072A |
|
30 |
30 |
$1K |
| 0154A |
|
24 |
22 |
$905.68 |
| 90461 |
|
855 |
760 |
$511.43 |
| 90671 |
|
358 |
302 |
$253.56 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
34 |
16 |
$182.92 |
| 92551 |
|
1,914 |
1,678 |
$133.87 |
| 90680 |
|
679 |
611 |
$107.63 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,419 |
811 |
$66.34 |
| 90686 |
|
1,396 |
1,273 |
$64.68 |
| 99173 |
|
2,101 |
1,834 |
$42.88 |
| 90688 |
|
251 |
240 |
$38.35 |
| 90656 |
|
235 |
227 |
$22.20 |
| 96127 |
|
54 |
51 |
$14.46 |
| 90633 |
|
293 |
265 |
$8.03 |
| 90744 |
|
252 |
228 |
$1.09 |
| 90698 |
|
823 |
732 |
$0.16 |
| 90670 |
|
804 |
725 |
$0.16 |
| 90685 |
|
479 |
426 |
$0.12 |
| 90697 |
|
114 |
92 |
$0.00 |
| G9459 |
Currently a tobacco non-user |
1,084 |
957 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,116 |
989 |
$0.00 |
| 96161 |
|
39 |
30 |
$0.00 |
| 90651 |
|
56 |
48 |
$0.00 |
| 91315 |
|
23 |
22 |
$0.00 |
| 91307 |
|
131 |
114 |
$0.00 |
| 90707 |
|
100 |
98 |
$0.00 |
| 90700 |
|
16 |
16 |
$0.00 |
| 91300 |
|
19 |
17 |
$0.00 |