| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,531 |
4,916 |
$206K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,802 |
1,659 |
$135K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,317 |
1,294 |
$102K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,165 |
2,183 |
$72K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,238 |
1,173 |
$55K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
933 |
873 |
$48K |
| 90671 |
|
732 |
698 |
$30K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,926 |
1,112 |
$29K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,322 |
1,245 |
$16K |
| 99460 |
|
202 |
199 |
$15K |
| 99383 |
|
141 |
140 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,586 |
1,545 |
$13K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
214 |
209 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
199 |
197 |
$12K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
143 |
141 |
$12K |
| 99384 |
|
105 |
105 |
$11K |
| 99382 |
|
79 |
79 |
$8K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
53 |
53 |
$5K |
| 87999 |
|
2,535 |
1,909 |
$4K |
| 90461 |
|
1,661 |
1,476 |
$3K |
| 87807 |
|
238 |
231 |
$2K |
| 99462 |
|
39 |
31 |
$1K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
248 |
240 |
$1K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
129 |
119 |
$1K |
| 99381 |
|
14 |
14 |
$1K |
| 83789 |
|
55 |
54 |
$1K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
59 |
51 |
$901.76 |
| 92552 |
|
28 |
27 |
$692.50 |
| 0072A |
|
15 |
14 |
$588.00 |
| 99000 |
|
55 |
54 |
$577.80 |
| 81003 |
|
122 |
112 |
$225.72 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
41 |
15 |
$181.06 |
| 94760 |
|
13 |
12 |
$2.06 |
| 90723 |
|
989 |
939 |
$0.00 |
| 90716 |
|
181 |
174 |
$0.00 |
| 90686 |
|
243 |
238 |
$0.00 |
| 36416 |
|
564 |
487 |
$0.00 |
| 90651 |
|
18 |
18 |
$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) |
55 |
54 |
$0.00 |
| 91307 |
|
43 |
38 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 90670 |
|
519 |
490 |
$0.00 |
| 90648 |
|
1,239 |
1,180 |
$0.00 |
| 90681 |
|
782 |
741 |
$0.00 |
| 90633 |
|
393 |
383 |
$0.00 |
| 90707 |
|
180 |
173 |
$0.00 |
| 90700 |
|
172 |
167 |
$0.00 |
| 99173 |
|
223 |
218 |
$0.00 |
| 90710 |
|
12 |
12 |
$0.00 |
| 99051 |
|
87 |
85 |
$0.00 |
| 90715 |
|
18 |
18 |
$0.00 |
| 90734 |
|
26 |
26 |
$0.00 |