| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,685 |
3,775 |
$18K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
237 |
231 |
$9K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,742 |
2,523 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
578 |
548 |
$4K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
562 |
501 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
144 |
134 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
223 |
219 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
542 |
521 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
751 |
698 |
$738.63 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
15 |
$76.08 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
334 |
320 |
$0.00 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
45 |
45 |
$0.00 |
| G9459 |
Currently a tobacco non-user |
48 |
45 |
$0.00 |
| 96127 |
|
193 |
177 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
106 |
95 |
$0.00 |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
31 |
27 |
$0.00 |