| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
2,072 |
1,786 |
$136K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,221 |
1,103 |
$114K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
998 |
961 |
$27K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
259 |
259 |
$24K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
203 |
203 |
$20K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,878 |
1,707 |
$19K |
| 99173 |
|
933 |
927 |
$17K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,380 |
1,362 |
$13K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
113 |
113 |
$10K |
| 92551 |
|
958 |
908 |
$9K |
| 1000F |
|
327 |
326 |
$4K |
| 92567 |
|
222 |
196 |
$3K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
117 |
110 |
$2K |
| 99215 |
Prolong outpt/office vis |
19 |
18 |
$2K |
| 94760 |
|
779 |
670 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
129 |
127 |
$1K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
14 |
13 |
$1K |
| 81002 |
|
467 |
458 |
$1K |
| 90461 |
|
43 |
43 |
$695.40 |
| 85018 |
|
138 |
138 |
$323.52 |
| 83655 |
|
14 |
14 |
$177.37 |
| 96127 |
|
205 |
200 |
$21.98 |
| 96160 |
|
320 |
312 |
$2.09 |
| G8482 |
Influenza immunization administered or previously received |
577 |
514 |
$0.00 |
| 1039F |
|
435 |
420 |
$0.00 |
| 1033F |
|
820 |
771 |
$0.00 |
| 4124F |
|
220 |
211 |
$0.00 |
| 1032F |
|
82 |
79 |
$0.00 |
| 90687 |
|
12 |
12 |
$0.00 |
| G8484 |
Influenza immunization was not administered, reason not given |
144 |
125 |
$0.00 |
| G8483 |
Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) |
476 |
425 |
$0.00 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
12 |
12 |
$0.00 |
| 90734 |
|
13 |
13 |
$0.00 |
| H0049 |
Alcohol and/or drug screening |
372 |
324 |
$0.00 |
| 90686 |
|
285 |
282 |
$0.00 |
| 3008F |
|
1,127 |
1,112 |
$0.00 |
| 2000F |
|
582 |
580 |
$0.00 |
| 1030F |
|
959 |
955 |
$0.00 |
| 3351F |
|
201 |
198 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
81 |
81 |
$0.00 |
| 1031F |
|
1,549 |
1,428 |
$0.00 |
| 1220F |
|
425 |
402 |
$0.00 |
| 1038F |
|
12 |
12 |
$0.00 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
28 |
28 |
$0.00 |
| 90651 |
|
13 |
13 |
$0.00 |