| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
900 |
838 |
$29K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
764 |
724 |
$13K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
715 |
672 |
$12K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
747 |
656 |
$12K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,161 |
2,029 |
$9K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
276 |
265 |
$8K |
| 99072 |
|
397 |
342 |
$2K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
54 |
52 |
$1K |
| 90461 |
|
1,000 |
926 |
$1K |
| 92552 |
|
171 |
156 |
$938.57 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,055 |
1,942 |
$858.18 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
236 |
221 |
$674.00 |
| 99174 |
|
128 |
117 |
$424.68 |
| 0071A |
|
12 |
12 |
$314.10 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
25 |
25 |
$61.31 |
| 99173 |
|
277 |
259 |
$40.48 |
| 90677 |
|
183 |
173 |
$0.20 |
| 90670 |
|
161 |
150 |
$0.09 |
| 90686 |
|
228 |
212 |
$0.05 |
| 90656 |
|
139 |
136 |
$0.04 |
| 90698 |
|
43 |
39 |
$0.04 |
| 91307 |
|
16 |
12 |
$0.02 |
| 90680 |
|
68 |
63 |
$0.02 |
| 90744 |
|
15 |
14 |
$0.01 |
| 90697 |
|
29 |
26 |
$0.00 |
| 90633 |
|
30 |
27 |
$0.00 |