| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,930 |
5,479 |
$583K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
6,456 |
5,221 |
$371K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,431 |
1,939 |
$197K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,908 |
3,389 |
$157K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,646 |
1,526 |
$144K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
731 |
684 |
$64K |
| 90461 |
|
2,133 |
1,896 |
$53K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,492 |
1,175 |
$37K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
885 |
790 |
$26K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
281 |
244 |
$25K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,349 |
3,073 |
$20K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
3,009 |
1,209 |
$19K |
| 96127 |
|
3,639 |
3,341 |
$14K |
| 99383 |
|
152 |
143 |
$14K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
157 |
149 |
$12K |
| 99382 |
|
100 |
96 |
$10K |
| 99401 |
|
1,132 |
977 |
$9K |
| 99384 |
|
65 |
64 |
$7K |
| 94760 |
|
2,464 |
1,947 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
601 |
556 |
$4K |
| 96160 |
|
2,011 |
1,818 |
$4K |
| 99460 |
|
46 |
38 |
$3K |
| 96161 |
|
1,456 |
1,272 |
$3K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
30 |
26 |
$2K |
| 99381 |
|
14 |
13 |
$1K |
| 0072A |
|
28 |
28 |
$857.32 |
| 0071A |
|
47 |
30 |
$787.02 |
| 0001A |
|
26 |
24 |
$755.40 |
| 90686 |
|
1,034 |
943 |
$748.43 |
| 0002A |
|
13 |
13 |
$493.40 |
| 99070 |
|
116 |
71 |
$490.51 |
| 36416 |
|
108 |
94 |
$373.73 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
17 |
15 |
$273.32 |
| 90651 |
|
50 |
43 |
$258.54 |
| 99072 |
|
10,554 |
8,082 |
$181.43 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
17 |
15 |
$124.67 |
| 87807 |
|
14 |
14 |
$103.88 |
| 99173 |
|
3,364 |
2,972 |
$35.09 |
| 90677 |
|
48 |
48 |
$0.18 |
| 91307 |
|
80 |
61 |
$0.12 |
| 90656 |
|
94 |
90 |
$0.03 |
| 90670 |
|
1,112 |
974 |
$0.00 |
| 90648 |
|
851 |
770 |
$0.00 |
| 90710 |
|
61 |
59 |
$0.00 |
| 90633 |
|
359 |
333 |
$0.00 |
| 90681 |
|
140 |
134 |
$0.00 |
| 90707 |
|
31 |
31 |
$0.00 |
| 90734 |
|
12 |
12 |
$0.00 |
| 91300 |
|
55 |
44 |
$0.00 |
| 90700 |
|
12 |
12 |
$0.00 |
| 97802 |
|
1,201 |
1,153 |
$0.00 |
| 3008F |
|
562 |
543 |
$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) |
108 |
94 |
$0.00 |
| 90723 |
|
570 |
522 |
$0.00 |
| 99000 |
|
75 |
68 |
$0.00 |
| 90647 |
|
58 |
53 |
$0.00 |
| 90696 |
|
13 |
12 |
$0.00 |
| 90716 |
|
16 |
15 |
$0.00 |