| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,443 |
3,045 |
$117K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,514 |
1,369 |
$113K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
778 |
761 |
$59K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
944 |
906 |
$39K |
| 99460 |
|
554 |
547 |
$38K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
704 |
675 |
$34K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
571 |
565 |
$30K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,079 |
983 |
$25K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
966 |
462 |
$11K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
104 |
103 |
$8K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
636 |
607 |
$8K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
889 |
845 |
$7K |
| 99462 |
|
204 |
160 |
$7K |
| 90461 |
|
829 |
727 |
$5K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
74 |
74 |
$4K |
| 90671 |
|
50 |
50 |
$4K |
| 99381 |
|
26 |
26 |
$2K |
| 99382 |
|
19 |
19 |
$2K |
| 83789 |
|
87 |
79 |
$2K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
20 |
20 |
$2K |
| 87807 |
|
140 |
133 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
125 |
115 |
$938.65 |
| 92552 |
|
29 |
27 |
$689.52 |
| 99000 |
|
87 |
78 |
$685.82 |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
82 |
79 |
$424.66 |
| 87999 |
|
1,474 |
1,052 |
$366.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
51 |
30 |
$288.05 |
| 81003 |
|
13 |
12 |
$21.78 |
| 90723 |
|
531 |
485 |
$0.00 |
| 36416 |
|
529 |
463 |
$0.00 |
| 90716 |
|
73 |
72 |
$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) |
87 |
79 |
$0.00 |
| 90686 |
|
84 |
74 |
$0.00 |
| 99173 |
|
205 |
196 |
$0.00 |
| 90681 |
|
420 |
387 |
$0.00 |
| 90670 |
|
636 |
588 |
$0.00 |
| 90648 |
|
635 |
590 |
$0.00 |
| 90707 |
|
73 |
72 |
$0.00 |
| 90633 |
|
40 |
39 |
$0.00 |
| 91300 |
|
17 |
13 |
$0.00 |