| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,101 |
745 |
$40K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,536 |
995 |
$38K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,189 |
765 |
$34K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,995 |
690 |
$26K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,946 |
1,337 |
$22K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,038 |
487 |
$20K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,879 |
1,378 |
$15K |
| 99460 |
|
218 |
121 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
576 |
216 |
$7K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
587 |
173 |
$6K |
| 99000 |
|
676 |
451 |
$5K |
| 90461 |
|
1,101 |
773 |
$4K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
408 |
289 |
$4K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
137 |
81 |
$4K |
| 99381 |
|
128 |
62 |
$4K |
| 92551 |
|
506 |
399 |
$3K |
| 99462 |
|
124 |
50 |
$2K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
20 |
20 |
$2K |
| 81000 |
|
426 |
304 |
$988.06 |
| 83655 |
|
112 |
85 |
$865.58 |
| 87807 |
|
145 |
79 |
$792.00 |
| 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) |
186 |
77 |
$315.00 |
| 99188 |
|
159 |
100 |
$236.25 |
| 96127 |
|
388 |
168 |
$220.50 |
| 90686 |
|
1,250 |
633 |
$183.58 |
| 36415 |
Collection of venous blood by venipuncture |
109 |
48 |
$173.25 |
| 90723 |
|
696 |
387 |
$88.98 |
| 90648 |
|
684 |
503 |
$58.10 |
| 85014 |
|
185 |
105 |
$46.97 |
| 96161 |
|
1,296 |
463 |
$12.65 |
| 90633 |
|
392 |
168 |
$5.37 |
| 90670 |
|
688 |
515 |
$0.70 |
| 90681 |
|
283 |
222 |
$0.28 |
| 90707 |
|
304 |
227 |
$0.15 |
| 90716 |
|
297 |
226 |
$0.14 |
| 99173 |
|
1,097 |
465 |
$0.00 |
| 90700 |
|
49 |
27 |
$0.00 |
| 36416 |
|
798 |
340 |
$0.00 |
| 90696 |
|
40 |
13 |
$0.00 |