| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,837 |
11,123 |
$759K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,171 |
3,159 |
$324K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,060 |
3,033 |
$294K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,689 |
2,555 |
$256K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
2,485 |
2,329 |
$233K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
10,830 |
10,693 |
$144K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
980 |
973 |
$109K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
8,330 |
5,197 |
$91K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,596 |
2,602 |
$34K |
| 99215 |
Prolong outpt/office vis |
185 |
179 |
$29K |
| 87428 |
|
458 |
444 |
$27K |
| 99493 |
|
112 |
112 |
$17K |
| 99000 |
|
1,203 |
1,162 |
$13K |
| 99494 |
|
131 |
131 |
$13K |
| 99381 |
|
108 |
107 |
$11K |
| 90474 |
|
966 |
950 |
$11K |
| 99383 |
|
70 |
68 |
$7K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
140 |
138 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
363 |
353 |
$6K |
| 99382 |
|
27 |
27 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
32 |
29 |
$3K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
123 |
50 |
$1K |
| 0081A |
|
37 |
28 |
$1K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
22 |
19 |
$1K |
| 90677 |
|
766 |
758 |
$914.16 |
| 0054A |
|
17 |
17 |
$768.00 |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
14 |
14 |
$667.19 |
| 90686 |
|
4,170 |
4,121 |
$353.50 |
| 90651 |
|
209 |
209 |
$293.60 |
| 90461 |
|
19 |
12 |
$158.53 |
| 90670 |
|
991 |
951 |
$0.00 |
| 90633 |
|
488 |
479 |
$0.00 |
| 90707 |
|
106 |
106 |
$0.00 |
| 91308 |
|
84 |
62 |
$0.00 |
| 90710 |
|
24 |
24 |
$0.00 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
178 |
170 |
$0.00 |
| 90734 |
|
25 |
25 |
$0.00 |
| 90697 |
|
1,095 |
1,068 |
$0.00 |
| 90680 |
|
1,080 |
1,041 |
$0.00 |
| 90698 |
|
153 |
152 |
$0.00 |
| 90656 |
|
690 |
689 |
$0.00 |
| 91307 |
|
105 |
103 |
$0.00 |
| 90716 |
|
97 |
97 |
$0.00 |
| 36416 |
|
15 |
14 |
$0.00 |
| 90619 |
|
14 |
14 |
$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) |
15 |
14 |
$0.00 |
| 91305 |
|
21 |
20 |
$0.00 |