| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99199 |
Unlisted special service, procedure or report |
37,010 |
19,962 |
$188K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,183 |
1,613 |
$168K |
| 99401 |
|
5,777 |
3,725 |
$163K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
1,882 |
1,404 |
$97K |
| 0241U |
Neonatal screening for hereditary disorders, genomic sequence analysis panel |
756 |
584 |
$94K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
1,937 |
1,503 |
$77K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
890 |
609 |
$71K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
609 |
501 |
$49K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,710 |
1,380 |
$18K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
197 |
168 |
$16K |
| D0145 |
Oral evaluation for a patient under three years of age |
326 |
264 |
$11K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
749 |
608 |
$9K |
| 96127 |
|
1,380 |
1,092 |
$9K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
219 |
118 |
$6K |
| 90670 |
|
266 |
184 |
$5K |
| D1206 |
Topical application of fluoride varnish |
324 |
263 |
$5K |
| 99215 |
Prolong outpt/office vis |
44 |
26 |
$4K |
| 92551 |
|
754 |
610 |
$2K |
| 96161 |
|
494 |
387 |
$2K |
| 90698 |
|
223 |
176 |
$2K |
| 90686 |
|
629 |
473 |
$1K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
32 |
20 |
$1K |
| 99173 |
|
931 |
755 |
$1K |
| 90680 |
|
120 |
87 |
$963.54 |
| 90480 |
|
18 |
15 |
$825.00 |
| 96160 |
|
208 |
178 |
$679.89 |
| 91321 |
|
17 |
14 |
$527.38 |
| 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) |
20 |
16 |
$123.08 |
| 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) |
13 |
13 |
$92.31 |
| 90633 |
|
33 |
24 |
$0.00 |
| 91307 |
|
44 |
30 |
$0.00 |
| 90656 |
|
78 |
65 |
$0.00 |
| 90677 |
|
38 |
38 |
$0.00 |
| 36416 |
|
12 |
12 |
$0.00 |