| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
39,347 |
33,104 |
$2.49M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
23,981 |
20,167 |
$2.30M |
| 99199 |
Unlisted special service, procedure or report |
329,655 |
159,455 |
$1.54M |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
19,482 |
16,929 |
$820K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
8,318 |
6,862 |
$749K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
7,218 |
6,283 |
$684K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
7,166 |
6,348 |
$677K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
3,409 |
2,973 |
$346K |
| 87798 |
Infectious agent detection by nucleic acid; not otherwise specified, amplified probe, each organism |
11,104 |
9,387 |
$315K |
| 99050 |
|
12,190 |
10,951 |
$304K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
10,625 |
9,058 |
$300K |
| 87636 |
Infectious agent detection by nucleic acid; SARS-CoV-2 and influenza virus types A and B |
2,269 |
1,912 |
$297K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
1,691 |
1,441 |
$221K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
4,702 |
3,778 |
$173K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
17,497 |
14,808 |
$155K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
14,373 |
12,485 |
$140K |
| 99401 |
|
2,907 |
2,310 |
$104K |
| 87428 |
|
1,698 |
1,361 |
$102K |
| D0145 |
Oral evaluation for a patient under three years of age |
2,748 |
2,309 |
$94K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
9,277 |
8,649 |
$92K |
| 96127 |
|
17,834 |
15,426 |
$84K |
| 87276 |
|
3,823 |
3,553 |
$51K |
| 87275 |
|
3,814 |
3,549 |
$51K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
2,499 |
2,268 |
$50K |
| 80061 |
Lipid panel |
2,765 |
2,371 |
$42K |
| D1206 |
Topical application of fluoride varnish |
2,686 |
2,261 |
$41K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
617 |
501 |
$30K |
| 87081 |
|
3,597 |
3,483 |
$24K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
581 |
526 |
$21K |
| 81003 |
|
7,521 |
6,511 |
$12K |
| 96161 |
|
3,686 |
3,195 |
$12K |
| 90651 |
|
216 |
198 |
$9K |
| 99215 |
Prolong outpt/office vis |
49 |
41 |
$7K |
| 99173 |
|
8,406 |
7,890 |
$5K |
| 90688 |
|
1,884 |
1,848 |
$4K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
450 |
397 |
$4K |
| 90686 |
|
3,162 |
2,617 |
$4K |
| 83655 |
|
260 |
247 |
$4K |
| 90734 |
|
246 |
222 |
$3K |
| 94760 |
|
33,933 |
27,745 |
$2K |
| 0072A |
|
50 |
36 |
$2K |
| 0071A |
|
57 |
37 |
$2K |
| 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) |
70 |
70 |
$2K |
| G0312 |
Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 5 to 15 mins time (this code is used for medicaid billing purposes) |
58 |
58 |
$2K |
| 96160 |
|
567 |
448 |
$1K |
| 36415 |
Collection of venous blood by venipuncture |
321 |
307 |
$847.61 |
| 87634 |
|
26 |
14 |
$421.32 |
| 82962 |
|
145 |
122 |
$383.79 |
| 90677 |
|
438 |
418 |
$269.38 |
| 90633 |
|
319 |
282 |
$221.03 |
| 36416 |
|
12,790 |
10,903 |
$200.14 |
| 92551 |
|
343 |
327 |
$188.20 |
| 90715 |
|
29 |
27 |
$77.86 |
| 90661 |
|
439 |
394 |
$37.10 |
| 90674 |
|
790 |
699 |
$30.31 |
| 90723 |
|
902 |
831 |
$0.14 |
| 90680 |
|
714 |
652 |
$0.02 |
| 90670 |
|
3,160 |
2,813 |
$0.02 |
| 90647 |
|
925 |
853 |
$0.01 |
| 99000 |
|
2,524 |
2,401 |
$0.00 |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
1,092 |
942 |
$0.00 |
| 99174 |
|
2,645 |
2,592 |
$0.00 |
| 3074F |
|
1,299 |
1,220 |
$0.00 |
| 90696 |
|
12 |
12 |
$0.00 |
| 3078F |
|
1,260 |
1,184 |
$0.00 |
| 90687 |
|
465 |
464 |
$0.00 |