| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
7,794 |
6,283 |
$365K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
20,481 |
16,980 |
$300K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
4,750 |
4,190 |
$84K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,737 |
3,025 |
$73K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,155 |
2,715 |
$48K |
| 90756 |
|
7,041 |
5,656 |
$29K |
| 90670 |
|
4,786 |
4,213 |
$23K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
746 |
662 |
$18K |
| 90681 |
|
2,542 |
2,254 |
$16K |
| D0120 |
Periodic oral evaluation - established patient |
542 |
492 |
$10K |
| D9999 |
Unspecified adjunctive procedure, by report |
540 |
492 |
$10K |
| 90697 |
|
1,216 |
1,121 |
$9K |
| 90723 |
|
1,690 |
1,476 |
$7K |
| D1206 |
Topical application of fluoride varnish |
585 |
531 |
$6K |
| 90647 |
|
1,728 |
1,486 |
$5K |
| 90633 |
|
1,113 |
979 |
$4K |
| 99460 |
|
45 |
39 |
$3K |
| 99072 |
|
4,111 |
2,900 |
$3K |
| 99174 |
|
5,956 |
5,157 |
$3K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
540 |
445 |
$2K |
| 90710 |
|
563 |
489 |
$2K |
| 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) |
49 |
37 |
$2K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
42 |
38 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
306 |
148 |
$1K |
| 85018 |
|
3,089 |
2,631 |
$805.56 |
| 99499 |
|
236 |
219 |
$771.85 |
| 90734 |
|
158 |
128 |
$538.00 |
| 90651 |
|
214 |
180 |
$444.06 |
| 99188 |
|
303 |
284 |
$383.32 |
| 99429 |
|
173 |
161 |
$365.44 |
| 83655 |
|
390 |
355 |
$355.66 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
308 |
153 |
$333.37 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
161 |
81 |
$308.89 |
| 90680 |
|
69 |
62 |
$301.86 |
| 90715 |
|
32 |
29 |
$246.59 |
| 90620 |
|
55 |
54 |
$202.14 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
95 |
84 |
$133.20 |
| 80061 |
Lipid panel |
107 |
81 |
$129.00 |
| 90655 |
|
44 |
43 |
$127.92 |
| 90696 |
|
27 |
24 |
$125.97 |
| 96127 |
|
103 |
100 |
$98.95 |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
60 |
32 |
$79.31 |
| 90658 |
|
107 |
105 |
$76.50 |
| 90686 |
|
258 |
255 |
$67.61 |
| 90672 |
|
44 |
27 |
$62.82 |
| 99173 |
|
298 |
285 |
$49.14 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
126 |
103 |
$42.69 |
| 90656 |
|
110 |
110 |
$39.30 |
| 90677 |
|
26 |
24 |
$36.68 |
| 87807 |
|
13 |
12 |
$34.06 |
| 90716 |
|
13 |
13 |
$20.62 |
| 90700 |
|
15 |
12 |
$20.62 |
| G2061 |
Qualified nonphysician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 5-10 minutes |
15 |
12 |
$5.98 |
| 90707 |
|
14 |
13 |
$0.00 |