| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,707 |
6,943 |
$369K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,477 |
8,453 |
$320K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,664 |
3,602 |
$276K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,847 |
3,622 |
$272K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
18,244 |
8,250 |
$198K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,737 |
1,707 |
$139K |
| 99429 |
|
4,552 |
4,454 |
$138K |
| 99381 |
|
847 |
796 |
$61K |
| 99383 |
|
686 |
677 |
$58K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
7,704 |
5,927 |
$57K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
589 |
578 |
$51K |
| 99382 |
|
519 |
508 |
$44K |
| 92553 |
|
1,451 |
1,441 |
$41K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
439 |
431 |
$24K |
| 90461 |
|
2,814 |
2,425 |
$19K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
599 |
577 |
$14K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,430 |
1,367 |
$14K |
| 99384 |
|
151 |
149 |
$14K |
| 99000 |
|
1,449 |
1,356 |
$13K |
| 99215 |
Prolong outpt/office vis |
146 |
142 |
$11K |
| 99050 |
|
863 |
815 |
$10K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
920 |
446 |
$9K |
| 96127 |
|
2,121 |
2,070 |
$9K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,234 |
1,209 |
$8K |
| 94664 |
|
1,072 |
1,024 |
$6K |
| 83655 |
|
523 |
515 |
$4K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
54 |
53 |
$4K |
| 94760 |
|
6,981 |
6,255 |
$4K |
| 92552 |
|
507 |
502 |
$3K |
| 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) |
293 |
280 |
$2K |
| 90480 |
|
73 |
72 |
$2K |
| 86580 |
|
247 |
247 |
$1K |
| 0111A |
|
32 |
32 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
78 |
75 |
$779.92 |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
4,010 |
3,826 |
$759.43 |
| 96160 |
|
2,583 |
2,492 |
$684.55 |
| 96381 |
|
41 |
41 |
$656.52 |
| 87807 |
|
84 |
82 |
$592.17 |
| 85018 |
|
371 |
363 |
$561.70 |
| 0112A |
|
15 |
15 |
$521.86 |
| 90677 |
|
948 |
932 |
$512.22 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
12 |
12 |
$488.92 |
| 99080 |
|
520 |
503 |
$304.50 |
| 81002 |
|
126 |
118 |
$301.24 |
| 90651 |
|
443 |
431 |
$236.54 |
| 96380 |
|
12 |
12 |
$222.96 |
| 90734 |
|
238 |
229 |
$92.76 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
12 |
12 |
$83.64 |
| 90700 |
|
621 |
607 |
$21.00 |
| 90686 |
|
1,004 |
969 |
$19.31 |
| 90697 |
|
1,748 |
1,726 |
$8.62 |
| 96161 |
|
688 |
670 |
$2.33 |
| 90381 |
|
107 |
101 |
$0.64 |
| 91311 |
|
87 |
84 |
$0.57 |
| 90687 |
|
585 |
577 |
$0.33 |
| 90688 |
|
349 |
340 |
$0.28 |
| 90672 |
|
94 |
94 |
$0.20 |
| 91321 |
|
62 |
62 |
$0.13 |
| 90380 |
|
27 |
26 |
$0.10 |
| 90715 |
|
80 |
77 |
$0.04 |
| 90670 |
|
2,299 |
2,269 |
$0.04 |
| 90680 |
|
2,153 |
2,105 |
$0.04 |
| 90744 |
|
461 |
450 |
$0.04 |
| 90710 |
|
1,270 |
1,240 |
$0.03 |
| 99173 |
|
2,618 |
2,577 |
$0.00 |
| 90633 |
|
1,679 |
1,651 |
$0.00 |
| 99072 |
|
542 |
477 |
$0.00 |
| 90648 |
|
409 |
398 |
$0.00 |
| 90658 |
|
263 |
263 |
$0.00 |
| 90707 |
|
41 |
41 |
$0.00 |
| 90656 |
|
83 |
83 |
$0.00 |
| 36416 |
|
1,555 |
1,472 |
$0.00 |
| 90696 |
|
336 |
324 |
$0.00 |
| 90698 |
|
661 |
651 |
$0.00 |
| 90716 |
|
30 |
30 |
$0.00 |
| 90660 |
|
22 |
22 |
$0.00 |