| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,972 |
3,778 |
$299K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,403 |
3,365 |
$267K |
| 99215 |
Prolong outpt/office vis |
2,852 |
2,725 |
$225K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,944 |
1,907 |
$161K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
15,521 |
6,309 |
$158K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,628 |
2,514 |
$136K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,260 |
3,122 |
$120K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
877 |
860 |
$78K |
| 99460 |
|
998 |
977 |
$76K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
1,110 |
1,081 |
$63K |
| 99462 |
|
1,173 |
931 |
$43K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,607 |
2,485 |
$35K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,167 |
1,046 |
$29K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,317 |
2,329 |
$27K |
| 90461 |
|
8,656 |
3,877 |
$26K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
1,061 |
1,032 |
$8K |
| 99000 |
|
400 |
385 |
$4K |
| 83655 |
|
363 |
354 |
$3K |
| 90480 |
|
39 |
39 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
36 |
36 |
$931.46 |
| S9441 |
Asthma education, non-physician provider, per session |
27 |
27 |
$591.97 |
| 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) |
291 |
275 |
$446.25 |
| 96127 |
|
121 |
117 |
$437.50 |
| 92551 |
|
40 |
38 |
$353.72 |
| 96160 |
|
61 |
61 |
$128.60 |
| 84030 |
|
12 |
12 |
$27.72 |
| 85018 |
|
13 |
13 |
$25.91 |
| 90697 |
|
546 |
539 |
$2.78 |
| 90677 |
|
523 |
512 |
$2.62 |
| 90686 |
|
1,501 |
1,474 |
$2.11 |
| 90619 |
|
100 |
100 |
$0.57 |
| 90621 |
|
44 |
43 |
$0.24 |
| 91321 |
|
30 |
30 |
$0.18 |
| 90710 |
|
1,058 |
1,046 |
$0.13 |
| 90670 |
|
2,227 |
2,197 |
$0.12 |
| 90651 |
|
197 |
195 |
$0.10 |
| 90734 |
|
95 |
92 |
$0.08 |
| 90633 |
|
1,304 |
1,288 |
$0.07 |
| 90680 |
|
1,826 |
1,797 |
$0.05 |
| 90744 |
|
834 |
821 |
$0.04 |
| 90700 |
|
451 |
445 |
$0.00 |
| 90648 |
|
413 |
408 |
$0.00 |
| 90681 |
|
50 |
50 |
$0.00 |
| 90715 |
|
27 |
27 |
$0.00 |
| 90707 |
|
15 |
15 |
$0.00 |
| 99173 |
|
40 |
38 |
$0.00 |
| 90696 |
|
239 |
238 |
$0.00 |
| 36416 |
|
1,725 |
1,680 |
$0.00 |
| 90698 |
|
1,431 |
1,409 |
$0.00 |
| 90656 |
|
187 |
187 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
43 |
43 |
$0.00 |
| 90716 |
|
15 |
15 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
619 |
575 |
$0.00 |