| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,573 |
8,164 |
$940K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,896 |
5,449 |
$388K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,795 |
1,688 |
$114K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,375 |
1,282 |
$86K |
| 90688 |
|
4,242 |
3,997 |
$77K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,103 |
1,054 |
$71K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,011 |
962 |
$66K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,445 |
3,184 |
$45K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,155 |
1,083 |
$24K |
| 99401 |
|
713 |
664 |
$20K |
| 90687 |
|
961 |
917 |
$18K |
| 92551 |
|
3,239 |
3,047 |
$15K |
| 87807 |
|
1,357 |
1,274 |
$14K |
| 99173 |
|
3,584 |
3,366 |
$14K |
| 90651 |
|
690 |
651 |
$13K |
| 90670 |
|
657 |
639 |
$12K |
| 81002 |
|
2,963 |
2,734 |
$8K |
| 94667 |
|
436 |
380 |
$6K |
| 36415 |
Collection of venous blood by venipuncture |
2,974 |
2,796 |
$6K |
| D1206 |
Topical application of fluoride varnish |
331 |
314 |
$5K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
436 |
380 |
$4K |
| 90680 |
|
182 |
175 |
$3K |
| 90648 |
|
176 |
170 |
$3K |
| 94729 |
|
107 |
100 |
$3K |
| 94727 |
|
107 |
100 |
$3K |
| 90671 |
|
120 |
118 |
$2K |
| 90633 |
|
132 |
120 |
$2K |
| 90700 |
|
105 |
102 |
$2K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
74 |
70 |
$2K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
12 |
$2K |
| 90707 |
|
90 |
86 |
$2K |
| 90716 |
|
89 |
85 |
$2K |
| 90734 |
|
90 |
84 |
$2K |
| 90621 |
|
73 |
68 |
$1K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
170 |
131 |
$1K |
| 90697 |
|
53 |
52 |
$1K |
| 94375 |
|
43 |
41 |
$984.00 |
| 71046 |
Radiologic examination, chest; 2 views |
31 |
29 |
$547.96 |
| 90713 |
|
27 |
26 |
$534.33 |
| 90715 |
|
31 |
26 |
$494.75 |
| 74018 |
|
29 |
27 |
$454.22 |
| 90723 |
|
12 |
12 |
$237.48 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
92 |
69 |
$191.97 |
| 83655 |
|
12 |
12 |
$180.00 |
| 36416 |
|
69 |
67 |
$162.50 |
| D0145 |
Oral evaluation for a patient under three years of age |
14 |
12 |
$154.00 |
| G0315 |
Immunization counseling by a physician or other qualified health care professional for covid-19, ages under 21, 5-15 mins time (this code is used for the medicaid early and periodic screening, diagnostic, and treatment benefit (epsdt) |
60 |
59 |
$0.00 |