| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
446 |
409 |
$9K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
841 |
778 |
$8K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
115 |
104 |
$1K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
47 |
45 |
$1K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
62 |
58 |
$632.54 |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
21 |
13 |
$480.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
206 |
198 |
$365.05 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
706 |
631 |
$201.00 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
54 |
32 |
$53.81 |
| 92551 |
|
66 |
51 |
$32.79 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
84 |
75 |
$20.59 |
| 99173 |
|
67 |
51 |
$12.08 |
| 90670 |
|
27 |
27 |
$4.00 |
| 90686 |
|
70 |
47 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
16 |
13 |
$0.00 |
| 90688 |
|
61 |
55 |
$0.00 |
| 90651 |
|
15 |
12 |
$0.00 |
| G9459 |
Currently a tobacco non-user |
19 |
14 |
$0.00 |
| 90685 |
|
17 |
16 |
$0.00 |