| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99469 |
Subsequent inpatient neonatal critical care, per day, 28 days or younger |
6,176 |
687 |
$2.09M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
27,386 |
25,266 |
$1.37M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
22,214 |
20,465 |
$783K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
5,891 |
5,828 |
$460K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
5,252 |
5,168 |
$422K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
5,150 |
5,015 |
$391K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
4,403 |
4,151 |
$357K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
28,276 |
12,985 |
$283K |
| 99468 |
|
321 |
294 |
$244K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
3,006 |
2,880 |
$223K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
15,458 |
14,883 |
$203K |
| 99460 |
|
2,465 |
2,402 |
$186K |
| 99000 |
|
18,993 |
17,744 |
$178K |
| 90461 |
|
33,739 |
7,949 |
$67K |
| 99462 |
|
1,599 |
1,329 |
$59K |
| 99472 |
Subsequent inpatient pediatric critical care, per day, 2-5 years |
145 |
12 |
$58K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
678 |
664 |
$39K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,897 |
1,656 |
$39K |
| 99381 |
|
525 |
483 |
$37K |
| 92551 |
|
10,948 |
10,680 |
$35K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
1,359 |
1,298 |
$33K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
375 |
352 |
$27K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
508 |
485 |
$26K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,927 |
2,315 |
$21K |
| 90619 |
|
1,171 |
1,146 |
$19K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
408 |
184 |
$18K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,942 |
1,912 |
$17K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
199 |
192 |
$16K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
292 |
285 |
$13K |
| 99222 |
Initial hospital care, per day, moderate complexity |
120 |
112 |
$11K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
470 |
465 |
$11K |
| 83655 |
|
1,480 |
1,452 |
$11K |
| 99383 |
|
97 |
97 |
$8K |
| 87807 |
|
799 |
751 |
$8K |
| 0001A |
|
203 |
202 |
$8K |
| 0002A |
|
170 |
170 |
$7K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
841 |
817 |
$6K |
| 96160 |
|
3,533 |
3,382 |
$5K |
| 0072A |
|
139 |
120 |
$4K |
| 0071A |
|
148 |
129 |
$4K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
368 |
335 |
$4K |
| 99384 |
|
39 |
33 |
$3K |
| 99215 |
Prolong outpt/office vis |
28 |
26 |
$2K |
| 90473 |
|
250 |
247 |
$2K |
| 81002 |
|
582 |
545 |
$2K |
| 17110 |
|
19 |
18 |
$2K |
| 99382 |
|
17 |
17 |
$2K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
118 |
114 |
$1K |
| 87430 |
|
78 |
77 |
$1K |
| 17250 |
|
17 |
15 |
$1K |
| 99001 |
|
225 |
203 |
$946.08 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
14 |
13 |
$939.30 |
| 99356 |
|
28 |
26 |
$533.70 |
| 0081A |
|
14 |
14 |
$440.00 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
33 |
31 |
$326.52 |
| 85018 |
|
518 |
507 |
$257.57 |
| 90686 |
|
3,262 |
3,212 |
$257.03 |
| 96380 |
|
12 |
12 |
$210.00 |
| 94660 |
|
750 |
77 |
$101.60 |
| 90661 |
|
110 |
108 |
$78.35 |
| 90656 |
|
288 |
287 |
$19.22 |
| 90660 |
|
105 |
104 |
$10.50 |
| 90697 |
|
2,499 |
2,464 |
$5.68 |
| J7611 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, concentrated form, 1 mg |
12 |
12 |
$4.32 |
| 90677 |
|
1,205 |
1,199 |
$2.40 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
29 |
25 |
$0.96 |
| 90620 |
|
1,072 |
1,047 |
$0.24 |
| 90651 |
|
1,752 |
1,715 |
$0.08 |
| 90381 |
|
12 |
12 |
$0.02 |
| 90734 |
|
370 |
348 |
$0.02 |
| 90672 |
|
505 |
488 |
$0.02 |
| 90744 |
|
67 |
65 |
$0.01 |
| 90710 |
|
1,790 |
1,763 |
$0.01 |
| 90670 |
|
3,330 |
3,280 |
$0.01 |
| 90380 |
|
13 |
13 |
$0.01 |
| 36416 |
|
3,361 |
3,048 |
$0.00 |
| 90723 |
|
949 |
923 |
$0.00 |
| 90647 |
|
546 |
528 |
$0.00 |
| 90698 |
|
602 |
592 |
$0.00 |
| 91307 |
|
316 |
258 |
$0.00 |
| 90696 |
|
824 |
812 |
$0.00 |
| 36415 |
Collection of venous blood by venipuncture |
1,606 |
1,488 |
$0.00 |
| 90716 |
|
86 |
85 |
$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) |
148 |
130 |
$0.00 |
| 99173 |
|
11,115 |
10,768 |
$0.00 |
| 90633 |
|
2,102 |
2,076 |
$0.00 |
| 90707 |
|
112 |
111 |
$0.00 |
| 90681 |
|
1,897 |
1,871 |
$0.00 |
| 90715 |
|
805 |
788 |
$0.00 |
| 91300 |
|
465 |
425 |
$0.00 |
| 87633 |
Infectious agent detection by nucleic acid, respiratory virus, 12-25 targets |
156 |
149 |
$0.00 |
| 99072 |
|
73 |
72 |
$0.00 |
| 91308 |
|
16 |
16 |
$0.00 |
| 90685 |
|
54 |
49 |
$0.00 |