| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
8,872 |
7,225 |
$491K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,219 |
2,881 |
$254K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,984 |
4,511 |
$215K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
2,485 |
2,278 |
$209K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,659 |
1,482 |
$138K |
| 90671 |
|
576 |
554 |
$65K |
| 90461 |
|
3,131 |
2,851 |
$62K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,694 |
1,506 |
$51K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
543 |
494 |
$45K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,188 |
1,080 |
$22K |
| 99383 |
|
208 |
197 |
$19K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
180 |
171 |
$17K |
| 99188 |
|
1,034 |
919 |
$10K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
495 |
460 |
$10K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,162 |
1,051 |
$9K |
| 92551 |
|
2,332 |
2,146 |
$8K |
| 99382 |
|
85 |
72 |
$7K |
| 99460 |
|
81 |
69 |
$5K |
| 99384 |
|
40 |
38 |
$5K |
| 90651 |
|
121 |
116 |
$4K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
79 |
66 |
$4K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
463 |
423 |
$3K |
| 99381 |
|
15 |
14 |
$1K |
| 90686 |
|
1,234 |
1,130 |
$1K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
152 |
64 |
$1K |
| 36416 |
|
1,245 |
1,079 |
$974.14 |
| 87807 |
|
149 |
136 |
$936.26 |
| 83655 |
|
164 |
133 |
$906.61 |
| 99201 |
|
32 |
24 |
$549.09 |
| 85018 |
|
452 |
403 |
$482.69 |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
33 |
30 |
$441.12 |
| 90744 |
|
266 |
244 |
$284.50 |
| 84030 |
|
179 |
155 |
$146.25 |
| 90648 |
|
1,366 |
1,251 |
$111.10 |
| 90700 |
|
160 |
148 |
$111.10 |
| 94664 |
|
33 |
30 |
$92.58 |
| 90698 |
|
906 |
825 |
$0.00 |
| 90723 |
|
573 |
537 |
$0.00 |
| 90680 |
|
441 |
398 |
$0.00 |
| 99000 |
|
179 |
155 |
$0.00 |
| 90696 |
|
136 |
122 |
$0.00 |
| 94760 |
|
33 |
30 |
$0.00 |
| 90716 |
|
226 |
207 |
$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) |
179 |
155 |
$0.00 |
| 90656 |
|
99 |
99 |
$0.00 |
| 90633 |
|
1,123 |
1,034 |
$0.00 |
| 90681 |
|
434 |
404 |
$0.00 |
| 99173 |
|
2,368 |
2,169 |
$0.00 |
| 90670 |
|
1,887 |
1,705 |
$0.00 |
| 90715 |
|
74 |
72 |
$0.00 |
| 90707 |
|
203 |
184 |
$0.00 |
| 90734 |
|
145 |
135 |
$0.00 |
| 90710 |
|
147 |
135 |
$0.00 |