| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
336 |
297 |
$32K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
461 |
393 |
$32K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
241 |
231 |
$9K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
78 |
74 |
$6K |
| G0314 |
Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 16-30 mins time (this code is used for the medicaid early and periodic screening, diagnostic, and treatment benefit (epsdt) |
155 |
153 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
133 |
129 |
$2K |
| 99401 |
|
88 |
87 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
28 |
28 |
$644.84 |
| 96161 |
|
177 |
166 |
$323.05 |
| 96160 |
|
116 |
99 |
$221.36 |
| 99177 |
|
61 |
60 |
$177.30 |
| 97802 |
|
48 |
47 |
$5.00 |
| 90461 |
|
52 |
49 |
$0.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
249 |
240 |
$0.00 |
| 90677 |
|
13 |
13 |
$0.00 |
| 3510F |
|
82 |
79 |
$0.00 |
| 90656 |
|
55 |
55 |
$0.00 |
| 90686 |
|
36 |
34 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
15 |
14 |
$0.00 |