| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
15,018 |
13,698 |
$553K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,861 |
3,840 |
$324K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,805 |
3,783 |
$302K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,975 |
2,944 |
$269K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,355 |
4,153 |
$225K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,852 |
2,692 |
$221K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
17,728 |
8,295 |
$190K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
4,512 |
4,318 |
$175K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
6,639 |
3,238 |
$90K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,644 |
3,537 |
$50K |
| 92552 |
|
2,270 |
2,257 |
$48K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,038 |
2,910 |
$33K |
| 99381 |
|
244 |
244 |
$21K |
| 90461 |
|
2,614 |
2,210 |
$16K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
555 |
547 |
$8K |
| 87807 |
|
693 |
657 |
$7K |
| 99383 |
|
80 |
77 |
$7K |
| 0071A |
|
75 |
75 |
$3K |
| 90480 |
|
86 |
85 |
$2K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
274 |
262 |
$2K |
| 87420 |
|
181 |
174 |
$2K |
| 0072A |
|
50 |
50 |
$2K |
| 96160 |
|
1,156 |
1,138 |
$2K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
58 |
58 |
$1K |
| 99382 |
|
12 |
12 |
$1K |
| 81002 |
|
338 |
332 |
$957.78 |
| 99429 |
|
24 |
24 |
$777.52 |
| 0124A |
|
12 |
12 |
$360.00 |
| 90677 |
|
518 |
517 |
$274.97 |
| 90619 |
|
519 |
507 |
$162.01 |
| 90674 |
|
175 |
175 |
$117.19 |
| 90671 |
|
330 |
327 |
$2.19 |
| 91307 |
|
186 |
161 |
$0.87 |
| 90697 |
|
89 |
89 |
$0.43 |
| 91308 |
|
58 |
51 |
$0.28 |
| 91319 |
|
12 |
12 |
$0.07 |
| 91321 |
|
16 |
16 |
$0.07 |
| 91312 |
|
12 |
12 |
$0.07 |
| 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) |
12 |
12 |
$0.01 |
| 90698 |
|
888 |
874 |
$0.00 |
| 90688 |
|
471 |
467 |
$0.00 |
| 90651 |
|
996 |
986 |
$0.00 |
| 90620 |
|
660 |
641 |
$0.00 |
| 90716 |
|
333 |
332 |
$0.00 |
| 90686 |
|
1,912 |
1,904 |
$0.00 |
| 90656 |
|
63 |
63 |
$0.00 |
| 90680 |
|
1,336 |
1,327 |
$0.00 |
| 90744 |
|
269 |
262 |
$0.00 |
| 90696 |
|
245 |
241 |
$0.00 |
| 90723 |
|
313 |
313 |
$0.00 |
| 90657 |
|
36 |
36 |
$0.00 |
| 90707 |
|
355 |
354 |
$0.00 |
| 90670 |
|
1,205 |
1,190 |
$0.00 |
| 90633 |
|
1,191 |
1,182 |
$0.00 |
| 90710 |
|
421 |
414 |
$0.00 |
| 90700 |
|
516 |
515 |
$0.00 |
| 90715 |
|
367 |
355 |
$0.00 |
| 90734 |
|
372 |
357 |
$0.00 |
| 90648 |
|
942 |
935 |
$0.00 |
| 90658 |
|
268 |
268 |
$0.00 |
| 90685 |
|
66 |
66 |
$0.00 |
| 90672 |
|
12 |
12 |
$0.00 |
| J7510 |
Prednisolone oral, per 5 mg |
18 |
18 |
$0.00 |
| 90713 |
|
14 |
14 |
$0.00 |