| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
11,600 |
10,357 |
$883K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,510 |
2,432 |
$79K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,169 |
1,162 |
$71K |
| G0008 |
Administration of influenza virus vaccine |
2,297 |
2,264 |
$65K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
938 |
929 |
$57K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
856 |
832 |
$52K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
536 |
535 |
$34K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
336 |
326 |
$23K |
| G0009 |
Administration of pneumococcal vaccine |
478 |
475 |
$14K |
| 90686 |
|
2,208 |
2,178 |
$12K |
| 90832 |
Psychotherapy, 30 minutes with patient |
102 |
88 |
$11K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
146 |
142 |
$10K |
| C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
151 |
133 |
$3K |
| 90677 |
|
13 |
13 |
$2K |
| 90670 |
|
433 |
430 |
$2K |
| 96127 |
|
312 |
297 |
$2K |
| Q3014 |
Telehealth originating site facility fee |
138 |
131 |
$2K |
| 0054A |
|
74 |
74 |
$2K |
| 0124A |
|
151 |
151 |
$2K |
| 0001A |
|
37 |
36 |
$1K |
| 0002A |
|
32 |
32 |
$1K |
| D0145 |
Oral evaluation for a patient under three years of age |
18 |
18 |
$360.00 |
| 80305 |
|
174 |
172 |
$298.16 |
| 91320 |
|
55 |
54 |
$262.20 |
| 90480 |
|
85 |
84 |
$247.31 |
| 90734 |
|
37 |
37 |
$194.98 |
| D1206 |
Topical application of fluoride varnish |
15 |
15 |
$180.00 |
| 90651 |
|
43 |
43 |
$172.04 |
| 0004A |
|
117 |
116 |
$82.64 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
13 |
$21.42 |
| 83036 |
Hemoglobin; glycosylated (A1C) |
51 |
50 |
$19.42 |
| 83037 |
|
81 |
79 |
$9.71 |
| 87070 |
|
13 |
13 |
$8.80 |
| 81003 |
|
37 |
37 |
$4.50 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
1,494 |
1,480 |
$0.00 |
| 90715 |
|
67 |
66 |
$0.00 |
| 91300 |
|
167 |
156 |
$0.00 |
| 90633 |
|
128 |
128 |
$0.00 |
| 90671 |
|
70 |
70 |
$0.00 |
| 90648 |
|
12 |
12 |
$0.00 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
26 |
25 |
$0.00 |
| 91312 |
|
93 |
93 |
$0.00 |
| 90681 |
|
12 |
12 |
$0.00 |
| 90662 |
|
29 |
29 |
$0.00 |
| 0071A |
|
16 |
16 |
$0.00 |
| 36416 |
|
430 |
427 |
$0.00 |
| 90698 |
|
12 |
12 |
$0.00 |
| 0072A |
|
26 |
26 |
$0.00 |
| 91305 |
|
79 |
77 |
$0.00 |
| 91319 |
|
12 |
12 |
$0.00 |
| 90697 |
|
13 |
13 |
$0.00 |
| 91307 |
|
62 |
60 |
$0.00 |
| 90619 |
|
13 |
13 |
$0.00 |
| 90474 |
|
12 |
12 |
$0.00 |