| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,512 |
6,876 |
$511K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,686 |
3,432 |
$179K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
1,209 |
1,177 |
$51K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,319 |
2,248 |
$29K |
| 36415 |
Collection of venous blood by venipuncture |
6,610 |
6,033 |
$22K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
288 |
280 |
$5K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
94 |
93 |
$5K |
| 80053 |
Comprehensive metabolic panel |
527 |
512 |
$5K |
| 80061 |
Lipid panel |
402 |
395 |
$5K |
| 90686 |
|
639 |
627 |
$4K |
| 85027 |
|
695 |
671 |
$4K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
465 |
453 |
$4K |
| X5622 |
|
272 |
267 |
$3K |
| U0003 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r |
38 |
38 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
390 |
329 |
$3K |
| 92551 |
|
350 |
338 |
$2K |
| 99442 |
|
93 |
46 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
26 |
25 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
40 |
40 |
$2K |
| 84443 |
Thyroid stimulating hormone (TSH) |
112 |
111 |
$2K |
| 99188 |
|
181 |
178 |
$2K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
25 |
25 |
$2K |
| 96127 |
|
352 |
332 |
$1K |
| 90688 |
|
280 |
272 |
$1K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
15 |
15 |
$1K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
13 |
$970.24 |
| U0005 |
Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2 |
38 |
38 |
$957.37 |
| 95117 |
|
123 |
67 |
$937.21 |
| 0124A |
|
18 |
18 |
$611.07 |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
25 |
25 |
$598.10 |
| 86803 |
|
38 |
38 |
$526.79 |
| 99173 |
|
365 |
350 |
$511.45 |
| 87491 |
Infectious agent detection by nucleic acid; Chlamydia trachomatis, amplified probe |
12 |
12 |
$433.83 |
| 87591 |
Infectious agent detection by nucleic acid; Neisseria gonorrhoeae, amplified probe |
12 |
12 |
$433.83 |
| 80048 |
Basic metabolic panel (calcium, ionized) |
41 |
39 |
$360.54 |
| 90656 |
|
27 |
27 |
$335.05 |
| 90670 |
|
12 |
12 |
$216.23 |
| 99000 |
|
14 |
14 |
$171.08 |
| 81001 |
|
15 |
15 |
$42.55 |
| 90648 |
|
15 |
15 |
$11.09 |