| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,688 |
3,571 |
$165K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,118 |
3,087 |
$114K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,174 |
2,164 |
$93K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,558 |
1,459 |
$91K |
| G9920 |
Screening performed and negative |
3,563 |
3,543 |
$86K |
| 96156 |
|
2,794 |
2,791 |
$85K |
| A0427 |
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) |
1,378 |
1,290 |
$43K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,754 |
4,431 |
$34K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
933 |
917 |
$33K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,281 |
3,074 |
$30K |
| A0429 |
Ambulance service, basic life support, emergency transport (bls-emergency) |
863 |
783 |
$29K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
6,681 |
6,581 |
$26K |
| 99381 |
|
321 |
282 |
$26K |
| 90686 |
|
3,732 |
3,713 |
$17K |
| 99460 |
|
206 |
206 |
$11K |
| 90670 |
|
1,585 |
1,560 |
$10K |
| 92551 |
|
2,411 |
2,391 |
$9K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
301 |
296 |
$9K |
| A0425 |
Ground mileage, per statute mile |
2,298 |
2,067 |
$9K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
688 |
682 |
$8K |
| D1206 |
Topical application of fluoride varnish |
451 |
451 |
$8K |
| 90698 |
|
748 |
742 |
$6K |
| 90680 |
|
701 |
698 |
$6K |
| 99462 |
|
172 |
141 |
$5K |
| 0071A |
|
114 |
114 |
$5K |
| 0072A |
|
112 |
112 |
$4K |
| 90744 |
|
477 |
472 |
$4K |
| 90700 |
|
767 |
751 |
$3K |
| 90633 |
|
717 |
709 |
$3K |
| 92552 |
|
266 |
266 |
$3K |
| 90651 |
|
776 |
774 |
$2K |
| 92499 |
|
1,642 |
1,640 |
$2K |
| 90685 |
|
298 |
297 |
$2K |
| 90716 |
|
518 |
506 |
$2K |
| 90707 |
|
510 |
496 |
$2K |
| 99173 |
|
418 |
418 |
$1K |
| 90713 |
|
301 |
295 |
$1K |
| 90656 |
|
134 |
134 |
$936.00 |
| 90648 |
|
138 |
134 |
$784.00 |
| 90734 |
|
318 |
318 |
$748.04 |
| 83655 |
|
55 |
55 |
$699.92 |
| A0999 |
Unlisted ambulance service |
3,132 |
2,061 |
$640.95 |
| 90688 |
|
271 |
269 |
$623.19 |
| 96127 |
|
202 |
202 |
$564.52 |
| 92081 |
|
316 |
314 |
$478.80 |
| 93005 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report |
304 |
297 |
$471.04 |
| 90619 |
|
120 |
114 |
$350.02 |
| 90620 |
|
97 |
97 |
$331.28 |
| 90480 |
|
36 |
36 |
$324.00 |
| 90715 |
|
120 |
118 |
$302.80 |
| 99188 |
|
13 |
13 |
$158.96 |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
58 |
58 |
$114.54 |
| 90710 |
|
27 |
27 |
$99.52 |
| 99384 |
|
28 |
28 |
$58.68 |
| 99383 |
|
29 |
29 |
$54.59 |
| 99382 |
|
80 |
68 |
$51.46 |
| 85018 |
|
13 |
13 |
$32.67 |
| 90649 |
|
12 |
12 |
$18.00 |
| 81000 |
|
15 |
15 |
$2.87 |
| 3074F |
|
13 |
12 |
$0.00 |
| 90674 |
|
35 |
35 |
$0.00 |
| 97803 |
|
396 |
366 |
$0.00 |
| 90655 |
|
35 |
35 |
$0.00 |
| 3078F |
|
13 |
12 |
$0.00 |
| 90658 |
|
35 |
35 |
$0.00 |