| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,873 |
4,833 |
$332K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,234 |
2,087 |
$177K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,721 |
3,537 |
$166K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,428 |
1,374 |
$121K |
| 90461 |
|
2,304 |
2,209 |
$47K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
900 |
860 |
$31K |
| 92551 |
|
1,066 |
1,023 |
$8K |
| 99460 |
|
108 |
98 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
704 |
646 |
$6K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
52 |
50 |
$4K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
193 |
186 |
$4K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
101 |
86 |
$4K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
42 |
41 |
$4K |
| 99188 |
|
272 |
261 |
$3K |
| 99383 |
|
25 |
25 |
$3K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
69 |
68 |
$1K |
| 99382 |
|
15 |
13 |
$1K |
| 99462 |
|
46 |
39 |
$977.90 |
| 36416 |
|
216 |
198 |
$775.20 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
34 |
31 |
$470.39 |
| 87807 |
|
53 |
51 |
$325.67 |
| 83655 |
|
26 |
26 |
$255.78 |
| 94664 |
|
33 |
31 |
$246.88 |
| 85018 |
|
83 |
81 |
$135.34 |
| 90670 |
|
1,372 |
1,324 |
$125.54 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
15 |
15 |
$93.24 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
15 |
14 |
$81.80 |
| 84030 |
|
18 |
15 |
$57.21 |
| 90680 |
|
462 |
447 |
$50.14 |
| 94760 |
|
22 |
19 |
$22.91 |
| 90698 |
|
272 |
266 |
$0.00 |
| 90686 |
|
532 |
523 |
$0.00 |
| 90723 |
|
75 |
70 |
$0.00 |
| 90744 |
|
77 |
65 |
$0.00 |
| 90716 |
|
66 |
63 |
$0.00 |
| 90688 |
|
37 |
36 |
$0.00 |
| 99000 |
|
18 |
15 |
$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) |
18 |
15 |
$0.00 |
| 90647 |
|
15 |
15 |
$0.00 |
| 99173 |
|
1,131 |
1,080 |
$0.00 |
| 90671 |
|
205 |
195 |
$0.00 |
| 90648 |
|
542 |
518 |
$0.00 |
| 90685 |
|
155 |
153 |
$0.00 |
| 90707 |
|
39 |
37 |
$0.00 |
| 90633 |
|
358 |
340 |
$0.00 |
| 90700 |
|
14 |
12 |
$0.00 |
| 90681 |
|
37 |
36 |
$0.00 |