| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
620 |
509 |
$28K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
549 |
458 |
$26K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
476 |
460 |
$18K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,819 |
1,009 |
$15K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
182 |
182 |
$13K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
420 |
410 |
$10K |
| S9470 |
Nutritional counseling, dietitian visit |
492 |
489 |
$10K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
149 |
140 |
$8K |
| 99222 |
Initial hospital care, per day, moderate complexity |
85 |
78 |
$6K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
110 |
110 |
$6K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
134 |
104 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
327 |
263 |
$3K |
| 99223 |
Prolong inpt eval add15 m |
21 |
20 |
$2K |
| 99381 |
|
45 |
42 |
$2K |
| 90461 |
|
649 |
305 |
$1K |
| 99000 |
|
56 |
53 |
$444.54 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
108 |
107 |
$373.09 |
| 90651 |
|
88 |
88 |
$269.14 |
| 90658 |
|
223 |
222 |
$77.56 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
23 |
23 |
$0.14 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
210 |
209 |
$0.00 |
| 90723 |
|
277 |
270 |
$0.00 |
| 3351F |
|
470 |
431 |
$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) |
52 |
49 |
$0.00 |
| 90680 |
|
265 |
258 |
$0.00 |
| 90657 |
|
113 |
112 |
$0.00 |
| 90716 |
|
12 |
12 |
$0.00 |
| 3352F |
|
42 |
34 |
$0.00 |
| 90648 |
|
357 |
350 |
$0.00 |
| 90670 |
|
360 |
350 |
$0.00 |
| 90633 |
|
74 |
74 |
$0.00 |
| 90713 |
|
15 |
15 |
$0.00 |
| 90734 |
|
14 |
14 |
$0.00 |
| 90707 |
|
13 |
13 |
$0.00 |
| 90700 |
|
14 |
14 |
$0.00 |