| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
38,185 |
30,411 |
$597K |
| 87428 |
|
6,527 |
5,674 |
$339K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,961 |
3,792 |
$303K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,118 |
3,854 |
$289K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,379 |
3,138 |
$273K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,899 |
2,742 |
$200K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
18,707 |
8,558 |
$191K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
3,694 |
3,385 |
$150K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,928 |
2,756 |
$80K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
5,476 |
5,008 |
$58K |
| 99429 |
|
1,446 |
1,388 |
$46K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
4,800 |
2,290 |
$44K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
5,762 |
5,285 |
$43K |
| 99381 |
|
506 |
478 |
$35K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,608 |
2,592 |
$26K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
744 |
710 |
$23K |
| 90461 |
|
5,063 |
4,200 |
$22K |
| 99000 |
|
3,807 |
3,523 |
$16K |
| 92552 |
|
2,979 |
2,829 |
$15K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
4,718 |
4,139 |
$14K |
| 83655 |
|
1,292 |
1,206 |
$12K |
| 97169 |
|
551 |
539 |
$11K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,435 |
1,356 |
$9K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
847 |
647 |
$7K |
| 99051 |
|
1,895 |
1,723 |
$6K |
| 96160 |
|
3,705 |
3,413 |
$6K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
49 |
43 |
$4K |
| 99382 |
|
45 |
40 |
$3K |
| 87807 |
|
185 |
171 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
278 |
236 |
$946.88 |
| 99383 |
|
13 |
12 |
$757.53 |
| 96161 |
|
5,305 |
4,563 |
$629.52 |
| 81003 |
|
751 |
666 |
$497.35 |
| 96380 |
|
37 |
36 |
$440.00 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
129 |
111 |
$240.68 |
| 99050 |
|
13 |
13 |
$197.21 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
43 |
39 |
$194.12 |
| 90651 |
|
1,157 |
1,105 |
$191.27 |
| 90672 |
|
18 |
17 |
$175.00 |
| 90686 |
|
2,869 |
2,716 |
$51.70 |
| 85018 |
|
15 |
15 |
$9.95 |
| 36416 |
|
6,524 |
5,713 |
$6.53 |
| A7016 |
Dome and mouthpiece, used with small volume ultrasonic nebulizer |
43 |
39 |
$5.54 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
48 |
41 |
$2.70 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
43 |
39 |
$2.18 |
| 90677 |
|
798 |
775 |
$0.83 |
| 90621 |
|
817 |
770 |
$0.33 |
| 90620 |
|
24 |
23 |
$0.06 |
| 90680 |
|
1,631 |
1,551 |
$0.01 |
| 90648 |
|
935 |
910 |
$0.01 |
| 90670 |
|
1,719 |
1,636 |
$0.01 |
| 96127 |
|
1,922 |
1,776 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,762 |
1,650 |
$0.00 |
| 4037F |
|
3,011 |
2,853 |
$0.00 |
| 2001F |
|
16,026 |
14,860 |
$0.00 |
| 3008F |
|
10,533 |
9,883 |
$0.00 |
| 90619 |
|
452 |
413 |
$0.00 |
| 90696 |
|
268 |
256 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
10,864 |
10,160 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
13,476 |
12,686 |
$0.00 |
| 2000F |
|
4,379 |
4,077 |
$0.00 |
| 90381 |
|
41 |
39 |
$0.00 |
| 90697 |
|
1,468 |
1,393 |
$0.00 |
| 90723 |
|
462 |
452 |
$0.00 |
| 3752F |
|
54 |
53 |
$0.00 |
| 4140F |
|
321 |
299 |
$0.00 |
| 90716 |
|
17 |
17 |
$0.00 |
| 4015F |
|
60 |
57 |
$0.00 |
| 90744 |
|
18 |
18 |
$0.00 |
| 90656 |
|
339 |
336 |
$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) |
69 |
65 |
$0.00 |
| 3044F |
|
41 |
40 |
$0.00 |
| 94761 |
|
29 |
27 |
$0.00 |
| 90660 |
|
17 |
17 |
$0.00 |
| 90681 |
|
125 |
125 |
$0.00 |
| 4004F |
|
3,549 |
3,274 |
$0.00 |
| 99177 |
|
9,768 |
9,178 |
$0.00 |
| 90734 |
|
596 |
579 |
$0.00 |
| 90700 |
|
424 |
404 |
$0.00 |
| 90633 |
|
1,218 |
1,157 |
$0.00 |
| 3725F |
|
4,753 |
4,415 |
$0.00 |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
2,106 |
1,912 |
$0.00 |
| 5250F |
|
1,067 |
972 |
$0.00 |
| 90710 |
|
1,091 |
1,049 |
$0.00 |
| 99173 |
|
869 |
861 |
$0.00 |
| 90715 |
|
388 |
371 |
$0.00 |
| 99072 |
|
192 |
180 |
$0.00 |
| 90707 |
|
17 |
17 |
$0.00 |
| 90713 |
|
20 |
19 |
$0.00 |
| 94664 |
|
13 |
12 |
$0.00 |