| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,933 |
1,886 |
$139K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,794 |
1,790 |
$128K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
9,090 |
3,728 |
$94K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
784 |
782 |
$59K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
367 |
364 |
$28K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
553 |
540 |
$25K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
252 |
252 |
$19K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,190 |
1,173 |
$16K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
255 |
251 |
$15K |
| 99460 |
|
192 |
191 |
$15K |
| 87634 |
|
276 |
267 |
$14K |
| 99000 |
|
1,600 |
1,527 |
$14K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,128 |
556 |
$14K |
| 90461 |
|
2,501 |
2,203 |
$9K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,101 |
771 |
$9K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
13 |
13 |
$8K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
200 |
199 |
$7K |
| 90686 |
|
1,232 |
1,227 |
$3K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
108 |
108 |
$3K |
| 99381 |
|
36 |
36 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
227 |
219 |
$2K |
| 90715 |
|
152 |
152 |
$2K |
| 87807 |
|
150 |
146 |
$1K |
| 85018 |
|
885 |
880 |
$1K |
| 81002 |
|
393 |
365 |
$928.56 |
| 90674 |
|
31 |
31 |
$660.97 |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
12 |
12 |
$541.40 |
| 92552 |
|
171 |
171 |
$290.18 |
| 90651 |
|
64 |
64 |
$272.23 |
| 94760 |
|
358 |
350 |
$270.50 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
28 |
24 |
$201.43 |
| 81025 |
|
12 |
12 |
$72.30 |
| 90680 |
|
1,052 |
1,048 |
$0.00 |
| 36416 |
|
453 |
451 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
278 |
270 |
$0.00 |
| 90723 |
|
347 |
344 |
$0.00 |
| 90697 |
|
127 |
127 |
$0.00 |
| 90677 |
|
345 |
345 |
$0.00 |
| 90619 |
|
31 |
31 |
$0.00 |
| 90698 |
|
133 |
133 |
$0.00 |
| 90696 |
|
46 |
46 |
$0.00 |
| 90710 |
|
480 |
477 |
$0.00 |
| 90670 |
|
1,115 |
1,106 |
$0.00 |
| 90648 |
|
779 |
775 |
$0.00 |
| 90633 |
|
615 |
612 |
$0.00 |
| 99173 |
|
472 |
470 |
$0.00 |
| 90700 |
|
50 |
50 |
$0.00 |
| 90685 |
|
159 |
158 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |