| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,721 |
8,730 |
$447K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,472 |
2,386 |
$179K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,441 |
2,318 |
$166K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
7,460 |
7,210 |
$160K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
10,044 |
4,054 |
$86K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
623 |
610 |
$47K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,064 |
1,478 |
$39K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
804 |
767 |
$32K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
647 |
617 |
$21K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,619 |
1,567 |
$21K |
| 99177 |
|
2,388 |
2,320 |
$14K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,668 |
1,594 |
$12K |
| 90461 |
|
2,455 |
2,050 |
$10K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,079 |
571 |
$8K |
| 87807 |
|
682 |
662 |
$7K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
976 |
894 |
$6K |
| 99381 |
|
86 |
81 |
$5K |
| 92587 |
|
695 |
671 |
$4K |
| 90474 |
|
193 |
169 |
$1K |
| 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) |
40 |
38 |
$476.00 |
| 96380 |
|
27 |
27 |
$473.16 |
| 92551 |
|
28 |
28 |
$137.87 |
| 90473 |
|
13 |
13 |
$78.40 |
| 81002 |
|
12 |
12 |
$35.04 |
| 96127 |
|
12 |
12 |
$14.00 |
| 90697 |
|
761 |
737 |
$1.27 |
| 90677 |
|
298 |
292 |
$0.34 |
| 90633 |
|
592 |
564 |
$0.00 |
| 90648 |
|
102 |
100 |
$0.00 |
| 90670 |
|
1,968 |
1,839 |
$0.00 |
| 90681 |
|
75 |
75 |
$0.00 |
| 90707 |
|
75 |
74 |
$0.00 |
| 90700 |
|
83 |
83 |
$0.00 |
| 90672 |
|
12 |
12 |
$0.00 |
| 90658 |
|
38 |
38 |
$0.00 |
| 90680 |
|
1,121 |
1,056 |
$0.00 |
| 90744 |
|
80 |
70 |
$0.00 |
| 90657 |
|
124 |
124 |
$0.00 |
| 90656 |
|
25 |
25 |
$0.00 |
| 90686 |
|
827 |
812 |
$0.00 |
| 90698 |
|
307 |
268 |
$0.00 |
| 90716 |
|
126 |
125 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 96161 |
|
64 |
64 |
$0.00 |