| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,025 |
10,472 |
$204K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,380 |
3,115 |
$90K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,874 |
1,827 |
$61K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,861 |
1,806 |
$56K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,344 |
1,231 |
$40K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,381 |
1,365 |
$40K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,370 |
2,210 |
$18K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
432 |
427 |
$17K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,242 |
1,181 |
$15K |
| 99072 |
|
1,855 |
1,675 |
$9K |
| 92552 |
|
882 |
836 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
429 |
401 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
297 |
137 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
50 |
50 |
$930.69 |
| 86580 |
|
367 |
350 |
$887.31 |
| 96127 |
|
2,061 |
1,988 |
$883.39 |
| 99173 |
|
921 |
867 |
$390.03 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
231 |
230 |
$107.97 |
| S9999 |
Sales tax |
560 |
463 |
$25.01 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,798 |
1,705 |
$0.00 |
| G9903 |
Patient screened for tobacco use and identified as a tobacco non-user |
13 |
13 |
$0.00 |