| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
489 |
465 |
$10K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
901 |
826 |
$10K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
328 |
321 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
188 |
188 |
$5K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
124 |
118 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
121 |
111 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
454 |
439 |
$3K |
| 99072 |
|
756 |
679 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
516 |
472 |
$743.19 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
40 |
36 |
$368.83 |
| 81002 |
|
577 |
556 |
$231.58 |
| 90480 |
|
12 |
12 |
$218.40 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
129 |
96 |
$111.44 |
| 90686 |
|
159 |
151 |
$98.52 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
40 |
38 |
$28.26 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
281 |
270 |
$0.00 |
| 90656 |
|
38 |
33 |
$0.00 |