| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,020 |
1,798 |
$24K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
243 |
237 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
425 |
402 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
53 |
51 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
12 |
12 |
$720.00 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
13 |
12 |
$120.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
63 |
62 |
$81.67 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
30 |
25 |
$57.66 |
| 96127 |
|
31 |
28 |
$3.36 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
13 |
12 |
$0.00 |