| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
5,309 |
5,201 |
$123K |
| 99381 |
|
1,222 |
1,206 |
$107K |
| 96156 |
|
10,619 |
10,498 |
$75K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,284 |
12,336 |
$69K |
| 90697 |
|
1,918 |
1,902 |
$59K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,206 |
4,023 |
$24K |
| 99460 |
|
2,050 |
2,043 |
$20K |
| 97803 |
|
7,685 |
7,634 |
$15K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
5,703 |
5,653 |
$14K |
| 99462 |
|
2,049 |
1,617 |
$11K |
| 97802 |
|
521 |
515 |
$11K |
| 90680 |
|
3,765 |
3,744 |
$11K |
| 90670 |
|
3,978 |
3,930 |
$7K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,296 |
882 |
$7K |
| 99222 |
Initial hospital care, per day, moderate complexity |
793 |
788 |
$7K |
| 90698 |
|
2,379 |
2,355 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,436 |
3,411 |
$6K |
| 87428 |
|
1,121 |
1,087 |
$5K |
| 90744 |
|
1,567 |
1,555 |
$5K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,394 |
2,808 |
$4K |
| 90671 |
|
1,509 |
1,491 |
$3K |
| G9920 |
Screening performed and negative |
6,775 |
6,705 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,638 |
1,623 |
$2K |
| 92551 |
|
7,549 |
7,497 |
$2K |
| 90686 |
|
6,012 |
6,000 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
841 |
823 |
$884.38 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
42 |
39 |
$838.38 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
2,164 |
2,123 |
$767.40 |
| D1206 |
Topical application of fluoride varnish |
1,394 |
1,381 |
$766.26 |
| 85018 |
|
14,639 |
14,438 |
$609.16 |
| 94760 |
|
3,795 |
3,537 |
$459.29 |
| 90633 |
|
1,917 |
1,904 |
$447.75 |
| 83655 |
|
1,591 |
1,572 |
$398.97 |
| 90707 |
|
1,788 |
1,777 |
$369.00 |
| 90716 |
|
1,772 |
1,761 |
$369.00 |
| 90657 |
|
580 |
579 |
$261.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,110 |
1,047 |
$229.52 |
| 81002 |
|
7,147 |
7,071 |
$221.66 |
| 90700 |
|
854 |
850 |
$211.50 |
| 99188 |
|
249 |
243 |
$156.28 |
| 90658 |
|
1,116 |
1,116 |
$153.00 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
265 |
252 |
$151.69 |
| 90648 |
|
645 |
639 |
$108.00 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
13 |
13 |
$70.66 |
| 94664 |
|
101 |
100 |
$55.74 |
| 86580 |
|
1,359 |
1,349 |
$53.65 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
4,143 |
4,118 |
$43.62 |
| 87807 |
|
45 |
42 |
$40.71 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
10,078 |
9,976 |
$30.51 |
| 90696 |
|
339 |
337 |
$27.00 |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
744 |
732 |
$24.63 |
| 96127 |
|
1,056 |
1,038 |
$19.04 |
| 90651 |
|
128 |
128 |
$18.00 |
| 90734 |
|
80 |
80 |
$9.00 |
| 90619 |
|
68 |
68 |
$9.00 |
| 99173 |
|
7,275 |
7,225 |
$2.51 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
189 |
180 |
$1.32 |
| 90715 |
|
38 |
38 |
$0.00 |
| 90649 |
|
125 |
124 |
$0.00 |
| 69210 |
|
77 |
74 |
$0.00 |
| 90474 |
|
1,670 |
1,642 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
6,935 |
6,932 |
$0.00 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
160 |
160 |
$0.00 |