| 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) |
307 |
300 |
$12K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,495 |
1,266 |
$3K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
416 |
413 |
$962.97 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
213 |
204 |
$883.29 |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
261 |
261 |
$679.19 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
261 |
260 |
$355.85 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
755 |
739 |
$77.92 |
| 99421 |
|
305 |
296 |
$45.11 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
63 |
42 |
$22.00 |
| 96127 |
|
73 |
72 |
$7.26 |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
14 |
14 |
$0.00 |
| G2251 |
Brief communication technology-based service, e.g. virtual check-in, by a qualified health care professional who cannot report evaluation and management services, provided to an established patient, not originating from a related service provided within the previous 7 days nor leading to a service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of clinical discussion |
20 |
20 |
$0.00 |
| 90686 |
|
14 |
14 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
30 |
29 |
$0.00 |