| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,966 |
6,634 |
$373K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,546 |
3,374 |
$261K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
359 |
357 |
$35K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,116 |
1,089 |
$27K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
182 |
178 |
$17K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,680 |
1,574 |
$17K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
190 |
188 |
$17K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
183 |
140 |
$15K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
972 |
871 |
$9K |
| 90682 |
|
208 |
205 |
$9K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
83 |
82 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
334 |
330 |
$5K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
47 |
47 |
$4K |
| 99173 |
|
158 |
155 |
$3K |
| 90461 |
|
101 |
100 |
$2K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
189 |
185 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
174 |
85 |
$2K |
| S3005 |
Performance measurement, evaluation of patient self assessment, depression |
140 |
139 |
$1K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
409 |
409 |
$1K |
| 90686 |
|
496 |
491 |
$913.44 |
| 87081 |
|
151 |
150 |
$792.11 |
| 87428 |
|
14 |
13 |
$699.49 |
| 86403 |
|
62 |
59 |
$585.18 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
465 |
452 |
$204.75 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
454 |
446 |
$167.92 |
| 94760 |
|
94 |
85 |
$166.98 |
| G0446 |
Annual, face-to-face intensive behavioral therapy for cardiovascular disease, individual, 15 minutes |
38 |
38 |
$79.80 |
| 81000 |
|
14 |
14 |
$39.40 |
| 90685 |
|
12 |
12 |
$0.00 |
| 90670 |
|
13 |
13 |
$0.00 |
| 99406 |
|
12 |
12 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
30 |
30 |
$0.00 |
| 90698 |
|
14 |
14 |
$0.00 |
| 96127 |
|
13 |
13 |
$0.00 |