| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18,402 |
14,833 |
$1.20M |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
6,620 |
6,355 |
$158K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,527 |
1,477 |
$111K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,477 |
1,477 |
$103K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
1,336 |
1,336 |
$101K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
910 |
873 |
$76K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
982 |
982 |
$66K |
| 90461 |
|
1,803 |
1,785 |
$43K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
453 |
453 |
$39K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
2,015 |
2,009 |
$35K |
| 92551 |
|
3,806 |
3,775 |
$32K |
| 99401 |
|
1,043 |
1,040 |
$13K |
| 97803 |
|
2,173 |
2,160 |
$11K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
698 |
695 |
$9K |
| 90670 |
|
760 |
760 |
$8K |
| 99051 |
|
1,595 |
1,508 |
$8K |
| 99223 |
Prolong inpt eval add15 m |
54 |
54 |
$8K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
2,385 |
2,373 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,218 |
1,216 |
$6K |
| H0001 |
Alcohol and/or drug assessment |
393 |
393 |
$6K |
| 97802 |
|
908 |
906 |
$6K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
710 |
698 |
$5K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
162 |
161 |
$5K |
| 81002 |
|
2,316 |
2,304 |
$5K |
| G0444 |
Annual depression screening, 5 to 15 minutes |
470 |
469 |
$4K |
| 90686 |
|
2,388 |
2,386 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
3,990 |
3,933 |
$4K |
| A4250 |
Urine test or reagent strips or tablets (100 tablets or strips) |
1,408 |
1,398 |
$4K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
699 |
698 |
$3K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
444 |
424 |
$3K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
52 |
52 |
$3K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
28 |
28 |
$3K |
| 83655 |
|
251 |
251 |
$2K |
| 99173 |
|
2,948 |
2,936 |
$2K |
| 90671 |
|
177 |
177 |
$2K |
| 96161 |
|
2,190 |
2,178 |
$2K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
120 |
120 |
$2K |
| A4208 |
Syringe with needle, sterile 3 cc, each |
6,374 |
6,116 |
$2K |
| 99233 |
Prolong inpt eval add15 m |
20 |
17 |
$2K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
166 |
166 |
$2K |
| 96127 |
|
408 |
408 |
$1K |
| 90656 |
|
144 |
144 |
$1K |
| 0071A |
|
37 |
37 |
$1K |
| A4927 |
Gloves, non-sterile, per 100 |
2,487 |
2,396 |
$682.94 |
| 36400 |
|
109 |
107 |
$597.36 |
| A4928 |
Surgical mask, per 20 |
823 |
767 |
$577.17 |
| 90700 |
|
508 |
508 |
$500.00 |
| 90648 |
|
498 |
498 |
$450.00 |
| 0072A |
|
12 |
12 |
$391.23 |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
129 |
129 |
$390.00 |
| 90744 |
|
241 |
241 |
$316.69 |
| 99000 |
|
570 |
554 |
$221.34 |
| 90713 |
|
262 |
262 |
$200.00 |
| 90655 |
|
14 |
14 |
$189.74 |
| H0049 |
Alcohol and/or drug screening |
12 |
12 |
$125.00 |
| A4245 |
Alcohol wipes, per box |
899 |
868 |
$96.28 |
| 91307 |
|
74 |
70 |
$82.00 |
| 96160 |
|
41 |
39 |
$79.97 |
| 92558 |
|
87 |
87 |
$27.74 |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
68 |
67 |
$21.00 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
14 |
14 |
$15.00 |
| 3008F |
|
2,297 |
2,285 |
$0.30 |
| G8482 |
Influenza immunization administered or previously received |
76 |
75 |
$0.02 |
| 3725F |
|
227 |
227 |
$0.00 |
| A4649 |
Surgical supply; miscellaneous |
117 |
112 |
$0.00 |
| 90681 |
|
125 |
125 |
$0.00 |
| 3016F |
|
148 |
147 |
$0.00 |
| 90633 |
|
116 |
116 |
$0.00 |
| 90707 |
|
44 |
44 |
$0.00 |
| 90734 |
|
26 |
26 |
$0.00 |
| G8780 |
Counseling for diet and physical activity performed |
13 |
13 |
$0.00 |
| 1036F |
|
189 |
188 |
$0.00 |
| G8420 |
Bmi is documented within normal parameters and no follow-up plan is required |
849 |
847 |
$0.00 |
| 1220F |
|
143 |
142 |
$0.00 |
| 90698 |
|
209 |
209 |
$0.00 |
| 4293F |
|
150 |
150 |
$0.00 |
| 90716 |
|
93 |
93 |
$0.00 |
| 90651 |
|
13 |
13 |
$0.00 |