| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,074 |
1,921 |
$149K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,523 |
1,520 |
$108K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
8,047 |
3,286 |
$82K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
645 |
642 |
$48K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
430 |
418 |
$32K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
651 |
635 |
$30K |
| 99000 |
|
2,444 |
2,323 |
$22K |
| 87634 |
|
360 |
344 |
$18K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,260 |
1,241 |
$17K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,138 |
564 |
$14K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
237 |
236 |
$13K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
169 |
167 |
$12K |
| 99460 |
|
129 |
127 |
$10K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,167 |
826 |
$9K |
| 90461 |
|
2,328 |
2,055 |
$9K |
| 90715 |
|
431 |
429 |
$8K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
140 |
139 |
$5K |
| 59409 |
Vaginal delivery only (with or without episiotomy and/or forceps) |
12 |
12 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
371 |
361 |
$3K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
121 |
120 |
$3K |
| 90686 |
|
904 |
902 |
$2K |
| 85018 |
|
1,091 |
1,083 |
$1K |
| 76815 |
Ultrasound, pregnant uterus, real time with image documentation, limited |
31 |
29 |
$1K |
| 87807 |
|
129 |
127 |
$1K |
| 81002 |
|
436 |
422 |
$1K |
| 99381 |
|
12 |
12 |
$916.09 |
| 90674 |
|
31 |
30 |
$826.20 |
| 82950 |
|
241 |
238 |
$762.09 |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
173 |
160 |
$712.42 |
| 92552 |
|
101 |
101 |
$519.76 |
| 94760 |
|
559 |
540 |
$487.05 |
| 81025 |
|
41 |
38 |
$247.38 |
| 90670 |
|
1,119 |
1,118 |
$230.90 |
| 90677 |
|
298 |
298 |
$0.08 |
| 90697 |
|
212 |
212 |
$0.03 |
| 99173 |
|
410 |
409 |
$0.00 |
| 90633 |
|
524 |
522 |
$0.00 |
| 90648 |
|
688 |
688 |
$0.00 |
| 90710 |
|
359 |
359 |
$0.00 |
| 90685 |
|
137 |
137 |
$0.00 |
| 59426 |
|
37 |
26 |
$0.00 |
| 90700 |
|
14 |
14 |
$0.00 |
| 90680 |
|
1,044 |
1,042 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
892 |
864 |
$0.00 |
| 36416 |
|
712 |
706 |
$0.00 |
| 90619 |
|
12 |
12 |
$0.00 |
| 90696 |
|
28 |
28 |
$0.00 |
| 90723 |
|
337 |
337 |
$0.00 |
| 90651 |
|
71 |
71 |
$0.00 |
| 90698 |
|
124 |
124 |
$0.00 |