| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
18,688 |
13,166 |
$1.99M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
13,935 |
9,884 |
$985K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,370 |
2,823 |
$317K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,493 |
2,110 |
$237K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,284 |
1,735 |
$184K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,257 |
1,060 |
$129K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
11,425 |
9,167 |
$120K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
7,193 |
5,869 |
$54K |
| 96127 |
|
7,692 |
6,314 |
$36K |
| 90670 |
|
1,858 |
1,586 |
$36K |
| 90647 |
|
1,742 |
1,496 |
$33K |
| 90658 |
|
1,503 |
1,171 |
$27K |
| 36410 |
|
3,737 |
3,036 |
$24K |
| 90723 |
|
1,142 |
996 |
$23K |
| 90680 |
|
967 |
833 |
$19K |
| 90633 |
|
975 |
811 |
$19K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
1,972 |
1,429 |
$18K |
| 90716 |
|
865 |
705 |
$16K |
| 90707 |
|
853 |
691 |
$16K |
| 99383 |
|
155 |
137 |
$16K |
| 90651 |
|
762 |
643 |
$15K |
| 96160 |
|
6,131 |
5,018 |
$14K |
| 99381 |
|
128 |
102 |
$12K |
| 99173 |
|
4,766 |
3,972 |
$10K |
| 99382 |
|
88 |
74 |
$10K |
| 90657 |
|
432 |
327 |
$7K |
| 36415 |
Collection of venous blood by venipuncture |
1,626 |
1,316 |
$5K |
| 90696 |
|
245 |
211 |
$5K |
| 90733 |
|
182 |
170 |
$4K |
| 86328 |
|
91 |
76 |
$4K |
| 90715 |
|
171 |
159 |
$4K |
| 90700 |
|
136 |
113 |
$2K |
| 99385 |
|
16 |
13 |
$2K |
| 99384 |
|
15 |
15 |
$2K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
12 |
12 |
$1K |
| 90620 |
|
28 |
28 |
$651.84 |
| 0001A |
|
13 |
12 |
$520.00 |
| 2015F |
|
40 |
38 |
$375.00 |
| 90621 |
|
13 |
13 |
$302.25 |
| 90688 |
|
12 |
12 |
$279.36 |
| 83655 |
|
30 |
25 |
$242.32 |
| 96161 |
|
75 |
51 |
$114.69 |
| 97802 |
|
62 |
51 |
$90.09 |
| 94664 |
|
52 |
41 |
$28.00 |
| 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) |
17 |
13 |
$6.00 |
| 99401 |
|
32 |
27 |
$0.00 |