| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
5,141 |
5,114 |
$376K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,270 |
8,311 |
$304K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,138 |
4,043 |
$267K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
15,441 |
6,325 |
$150K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,875 |
1,867 |
$147K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,860 |
2,664 |
$128K |
| 99381 |
|
1,097 |
1,057 |
$58K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
7,970 |
6,650 |
$56K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
653 |
647 |
$54K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,542 |
1,515 |
$35K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
694 |
620 |
$27K |
| 99383 |
|
330 |
324 |
$26K |
| 90461 |
|
3,842 |
3,385 |
$20K |
| 99382 |
|
220 |
212 |
$17K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
918 |
880 |
$12K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
227 |
218 |
$11K |
| 87428 |
|
153 |
149 |
$10K |
| 92567 |
|
995 |
981 |
$9K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,090 |
1,054 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
444 |
215 |
$6K |
| 92551 |
|
1,170 |
1,165 |
$4K |
| 99384 |
|
42 |
41 |
$3K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,554 |
1,471 |
$3K |
| 87807 |
|
211 |
206 |
$2K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
36 |
36 |
$1K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
44 |
42 |
$581.13 |
| V5008 |
Hearing screening |
1,265 |
1,250 |
$351.00 |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
16 |
14 |
$297.11 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
81 |
43 |
$243.04 |
| 81002 |
|
25 |
25 |
$73.00 |
| 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) |
415 |
388 |
$17.50 |
| 90677 |
|
250 |
244 |
$1.35 |
| 90697 |
|
241 |
235 |
$1.21 |
| 90686 |
|
1,132 |
1,118 |
$0.08 |
| 90744 |
|
717 |
706 |
$0.01 |
| 90633 |
|
1,086 |
1,075 |
$0.00 |
| 99173 |
|
3,015 |
2,977 |
$0.00 |
| 90670 |
|
2,079 |
2,058 |
$0.00 |
| 90710 |
|
165 |
163 |
$0.00 |
| 90681 |
|
811 |
794 |
$0.00 |
| 90707 |
|
396 |
391 |
$0.00 |
| 90700 |
|
2,530 |
2,489 |
$0.00 |
| 90713 |
|
1,372 |
1,350 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 96127 |
|
834 |
815 |
$0.00 |
| 90647 |
|
2,040 |
2,011 |
$0.00 |
| 90723 |
|
29 |
29 |
$0.00 |
| 90716 |
|
365 |
359 |
$0.00 |
| 36416 |
|
249 |
230 |
$0.00 |