| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
17,006 |
14,645 |
$258K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,997 |
1,946 |
$167K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,758 |
1,659 |
$140K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,520 |
1,478 |
$135K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,274 |
1,242 |
$123K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
9,219 |
3,904 |
$96K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,615 |
1,512 |
$61K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,073 |
3,398 |
$34K |
| 99381 |
|
292 |
242 |
$22K |
| 90461 |
|
3,153 |
2,543 |
$14K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,100 |
957 |
$10K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,676 |
1,593 |
$9K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
223 |
205 |
$7K |
| 86328 |
|
365 |
351 |
$5K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
188 |
175 |
$5K |
| 99050 |
|
93 |
91 |
$4K |
| 99383 |
|
41 |
39 |
$4K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
677 |
360 |
$4K |
| CP002 |
|
315 |
286 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
327 |
305 |
$2K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
32 |
32 |
$1K |
| 83655 |
|
151 |
142 |
$929.63 |
| 92587 |
|
161 |
147 |
$788.97 |
| 96160 |
|
832 |
753 |
$738.96 |
| 92551 |
|
1,013 |
1,001 |
$313.28 |
| 87807 |
|
93 |
90 |
$310.20 |
| 83026 |
|
122 |
113 |
$93.74 |
| 90686 |
|
446 |
426 |
$61.50 |
| 99429 |
|
12 |
12 |
$35.00 |
| 81002 |
|
28 |
27 |
$31.17 |
| 90723 |
|
389 |
370 |
$0.00 |
| 90698 |
|
116 |
109 |
$0.00 |
| 90697 |
|
255 |
249 |
$0.00 |
| 96127 |
|
1,730 |
1,045 |
$0.00 |
| 90680 |
|
727 |
695 |
$0.00 |
| 90620 |
|
30 |
29 |
$0.00 |
| S3620 |
Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d; phenylalanine (pku); and thyroxine, total) |
169 |
130 |
$0.00 |
| 90651 |
|
193 |
189 |
$0.00 |
| 90696 |
|
212 |
208 |
$0.00 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
15 |
15 |
$0.00 |
| 90710 |
|
687 |
672 |
$0.00 |
| 90633 |
|
783 |
761 |
$0.00 |
| 90715 |
|
139 |
137 |
$0.00 |
| 90648 |
|
771 |
744 |
$0.00 |
| 90700 |
|
297 |
292 |
$0.00 |
| 90670 |
|
1,406 |
1,355 |
$0.00 |
| 99173 |
|
1,171 |
1,157 |
$0.00 |
| 90734 |
|
379 |
368 |
$0.00 |
| 90681 |
|
191 |
190 |
$0.00 |
| 90685 |
|
74 |
72 |
$0.00 |
| 84030 |
|
169 |
130 |
$0.00 |
| 90707 |
|
13 |
13 |
$0.00 |