| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
12,924 |
11,323 |
$433K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,272 |
3,227 |
$242K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,659 |
2,509 |
$192K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,760 |
1,743 |
$141K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,737 |
2,566 |
$128K |
| 99429 |
|
2,626 |
2,592 |
$79K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
5,163 |
5,067 |
$54K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
5,685 |
3,751 |
$50K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,065 |
2,919 |
$41K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,461 |
1,382 |
$35K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
391 |
388 |
$34K |
| 99381 |
|
323 |
316 |
$23K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
290 |
287 |
$16K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
608 |
449 |
$14K |
| 90474 |
|
1,439 |
1,410 |
$12K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
345 |
335 |
$12K |
| 87807 |
|
447 |
427 |
$5K |
| 99383 |
|
52 |
50 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,381 |
4,328 |
$2K |
| 99382 |
|
13 |
13 |
$1K |
| 99000 |
|
45 |
45 |
$447.30 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
29 |
28 |
$380.88 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
18 |
18 |
$233.75 |
| 96160 |
|
139 |
137 |
$221.49 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
14 |
12 |
$205.24 |
| G9716 |
Bmi is documented as being outside of normal parameters, follow-up plan is not completed for documented medical reason |
334 |
333 |
$151.80 |
| 86580 |
|
13 |
13 |
$83.98 |
| 81002 |
|
14 |
12 |
$40.88 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
27 |
26 |
$2.81 |
| 90700 |
|
426 |
422 |
$0.00 |
| 90633 |
|
1,229 |
1,212 |
$0.00 |
| 90670 |
|
1,606 |
1,579 |
$0.00 |
| 90685 |
|
111 |
109 |
$0.00 |
| 90707 |
|
1,086 |
1,067 |
$0.00 |
| 99173 |
|
2,701 |
2,657 |
$0.00 |
| 90658 |
|
212 |
212 |
$0.00 |
| 90734 |
|
51 |
51 |
$0.00 |
| 90461 |
|
18 |
18 |
$0.00 |
| 90710 |
|
16 |
16 |
$0.00 |
| 90715 |
|
26 |
26 |
$0.00 |
| 90649 |
|
13 |
12 |
$0.00 |
| 90716 |
|
1,074 |
1,055 |
$0.00 |
| 90744 |
|
422 |
417 |
$0.00 |
| 90680 |
|
1,418 |
1,391 |
$0.00 |
| V5008 |
Hearing screening |
2,670 |
2,626 |
$0.00 |
| 90698 |
|
867 |
850 |
$0.00 |
| 90677 |
|
539 |
536 |
$0.00 |
| 90686 |
|
653 |
643 |
$0.00 |
| 90696 |
|
245 |
244 |
$0.00 |
| 90697 |
|
508 |
500 |
$0.00 |
| 90647 |
|
415 |
410 |
$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) |
64 |
64 |
$0.00 |