| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,866 |
3,509 |
$140K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,353 |
1,237 |
$102K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,076 |
1,074 |
$88K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
5,082 |
1,765 |
$67K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
556 |
537 |
$27K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
648 |
634 |
$25K |
| 99460 |
|
278 |
277 |
$19K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,398 |
737 |
$19K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
356 |
350 |
$18K |
| 99382 |
|
182 |
182 |
$16K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
160 |
160 |
$15K |
| 99383 |
|
144 |
144 |
$14K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
188 |
188 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
912 |
874 |
$11K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,184 |
1,181 |
$8K |
| 99381 |
|
81 |
80 |
$5K |
| 90671 |
|
974 |
969 |
$4K |
| 99462 |
|
119 |
77 |
$3K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
32 |
31 |
$3K |
| 99384 |
|
25 |
25 |
$3K |
| 83789 |
|
110 |
107 |
$2K |
| 90674 |
|
55 |
55 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
253 |
251 |
$2K |
| 99000 |
|
110 |
107 |
$937.00 |
| 87807 |
|
84 |
83 |
$865.15 |
| 96380 |
|
28 |
28 |
$561.12 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
66 |
60 |
$533.32 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
38 |
38 |
$522.86 |
| 92552 |
|
13 |
13 |
$406.12 |
| 81003 |
|
60 |
58 |
$106.92 |
| 87999 |
|
1,771 |
1,263 |
$9.00 |
| 90461 |
|
1,535 |
1,344 |
$2.40 |
| 90723 |
|
634 |
632 |
$0.00 |
| 36416 |
|
588 |
552 |
$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) |
110 |
107 |
$0.00 |
| 90716 |
|
158 |
158 |
$0.00 |
| 90696 |
|
79 |
79 |
$0.00 |
| 94760 |
|
52 |
47 |
$0.00 |
| 90686 |
|
18 |
18 |
$0.00 |
| 90381 |
|
13 |
13 |
$0.00 |
| 90648 |
|
850 |
848 |
$0.00 |
| 90707 |
|
175 |
175 |
$0.00 |
| 99051 |
|
59 |
59 |
$0.00 |
| 90710 |
|
84 |
84 |
$0.00 |
| 99173 |
|
196 |
193 |
$0.00 |
| 90681 |
|
593 |
591 |
$0.00 |
| 90633 |
|
288 |
288 |
$0.00 |
| 90700 |
|
144 |
144 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |