| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
15,651 |
14,383 |
$777K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21,281 |
19,115 |
$747K |
| 87428 |
|
10,564 |
8,244 |
$609K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,817 |
4,665 |
$342K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,522 |
3,424 |
$274K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,370 |
3,210 |
$238K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
21,369 |
9,867 |
$219K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,709 |
1,658 |
$139K |
| S8301 |
Infection control supplies, not otherwise specified |
26,322 |
22,814 |
$135K |
| 99429 |
|
3,537 |
3,428 |
$107K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
3,843 |
3,658 |
$91K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
6,361 |
6,015 |
$82K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
5,469 |
4,225 |
$42K |
| 97802 |
|
7,322 |
7,082 |
$41K |
| CP002 |
|
3,685 |
2,934 |
$35K |
| 92551 |
|
3,470 |
3,319 |
$25K |
| 99000 |
|
2,747 |
2,581 |
$21K |
| 90461 |
|
5,920 |
4,903 |
$20K |
| 99381 |
|
235 |
202 |
$16K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
940 |
855 |
$10K |
| 0071A |
|
194 |
193 |
$8K |
| 0072A |
|
168 |
167 |
$7K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
110 |
109 |
$6K |
| 90480 |
|
210 |
196 |
$6K |
| 87807 |
|
502 |
475 |
$5K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
181 |
174 |
$4K |
| 96160 |
|
5,719 |
4,726 |
$4K |
| 99050 |
|
272 |
262 |
$3K |
| 0112A |
|
79 |
78 |
$3K |
| 0111A |
|
93 |
92 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
122 |
121 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
119 |
117 |
$858.46 |
| 0001A |
|
20 |
20 |
$695.00 |
| 0002A |
|
15 |
15 |
$600.00 |
| 99051 |
|
1,520 |
1,472 |
$576.68 |
| 96380 |
|
16 |
16 |
$292.08 |
| 81003 |
|
129 |
125 |
$222.29 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
17 |
16 |
$149.63 |
| 90686 |
|
4,496 |
4,376 |
$17.52 |
| 90670 |
|
1,977 |
1,919 |
$0.00 |
| 90734 |
|
214 |
210 |
$0.00 |
| 99173 |
|
5,334 |
5,085 |
$0.00 |
| 90648 |
|
1,083 |
1,046 |
$0.00 |
| 90633 |
|
1,391 |
1,347 |
$0.00 |
| 90707 |
|
289 |
281 |
$0.00 |
| 90671 |
|
448 |
438 |
$0.00 |
| 91312 |
|
13 |
13 |
$0.00 |
| 90710 |
|
181 |
175 |
$0.00 |
| 91311 |
|
251 |
244 |
$0.00 |
| 91300 |
|
47 |
34 |
$0.00 |
| 91320 |
|
45 |
43 |
$0.00 |
| 90672 |
|
12 |
12 |
$0.00 |
| 91321 |
|
29 |
29 |
$0.00 |
| 91319 |
|
29 |
29 |
$0.00 |
| 36416 |
|
2,227 |
2,080 |
$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) |
221 |
190 |
$0.00 |
| 90697 |
|
288 |
285 |
$0.00 |
| 90698 |
|
964 |
940 |
$0.00 |
| 96127 |
|
2,489 |
2,381 |
$0.00 |
| 90677 |
|
519 |
492 |
$0.00 |
| 90723 |
|
925 |
889 |
$0.00 |
| 90680 |
|
1,894 |
1,833 |
$0.00 |
| 90716 |
|
291 |
283 |
$0.00 |
| 90696 |
|
185 |
180 |
$0.00 |
| 90651 |
|
406 |
393 |
$0.00 |
| 90656 |
|
522 |
519 |
$0.00 |
| 91316 |
|
33 |
32 |
$0.00 |
| 91305 |
|
49 |
46 |
$0.00 |
| 91307 |
|
480 |
445 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
18 |
18 |
$0.00 |
| 90381 |
|
21 |
21 |
$0.00 |