| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
96,928 |
87,105 |
$6.35M |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
101,536 |
92,969 |
$5.09M |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
81,723 |
77,657 |
$3.13M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
22,469 |
21,654 |
$1.78M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
23,391 |
21,267 |
$1.76M |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
16,572 |
16,027 |
$1.31M |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
9,447 |
8,799 |
$803K |
| 80050 |
General health panel |
5,011 |
4,845 |
$168K |
| 77067 |
Screening mammography, bilateral, including computer-aided detection |
1,431 |
1,362 |
$125K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
7,411 |
6,990 |
$125K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,403 |
1,318 |
$124K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
4,914 |
4,656 |
$105K |
| 80061 |
Lipid panel |
8,921 |
8,456 |
$100K |
| 99308 |
Subsequent nursing facility care, per day, straightforward |
4,004 |
868 |
$98K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
3,323 |
3,151 |
$79K |
| 0072A |
|
896 |
846 |
$66K |
| 0071A |
|
889 |
833 |
$65K |
| 99177 |
|
4,429 |
4,182 |
$62K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,910 |
1,786 |
$58K |
| 36415 |
Collection of venous blood by venipuncture |
23,493 |
21,894 |
$56K |
| 80053 |
Comprehensive metabolic panel |
7,071 |
6,579 |
$56K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
6,735 |
6,380 |
$54K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
591 |
578 |
$54K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
3,450 |
3,198 |
$48K |
| 92551 |
|
22,935 |
19,500 |
$41K |
| 99215 |
Prolong outpt/office vis |
569 |
473 |
$40K |
| 99443 |
|
403 |
384 |
$40K |
| 96127 |
|
10,977 |
9,727 |
$38K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
778 |
747 |
$34K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,293 |
1,772 |
$33K |
| 84443 |
Thyroid stimulating hormone (TSH) |
2,872 |
2,606 |
$31K |
| 77063 |
Screening digital breast tomosynthesis, bilateral |
863 |
829 |
$29K |
| 90480 |
|
902 |
879 |
$28K |
| 84439 |
|
3,208 |
3,043 |
$25K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
200 |
193 |
$24K |
| 87502 |
Infectious agent detection by nucleic acid, influenza virus, for multiple types or subtypes, includes all targets |
294 |
266 |
$23K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
4,052 |
3,756 |
$23K |
| 90686 |
|
22,381 |
18,238 |
$18K |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
2,737 |
2,493 |
$18K |
| 99381 |
|
212 |
204 |
$18K |
| 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) |
475 |
464 |
$15K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
220 |
197 |
$13K |
| 81001 |
|
5,148 |
4,761 |
$13K |
| 90670 |
|
7,733 |
6,644 |
$12K |
| Q0091 |
Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory |
784 |
735 |
$12K |
| 84481 |
|
911 |
861 |
$12K |
| 99173 |
|
24,922 |
21,318 |
$11K |
| 86803 |
|
785 |
747 |
$10K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
109 |
108 |
$9K |
| 71046 |
Radiologic examination, chest; 2 views |
362 |
332 |
$9K |
| 82043 |
|
1,889 |
1,796 |
$9K |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
704 |
653 |
$8K |
| 0124A |
|
108 |
107 |
$8K |
| 96161 |
|
3,210 |
2,644 |
$8K |
| 99205 |
Prolong outpt/office vis |
66 |
66 |
$8K |
| 99497 |
|
512 |
418 |
$8K |
| 82570 |
|
1,892 |
1,797 |
$8K |
| 99188 |
|
654 |
620 |
$8K |
| 82607 |
|
616 |
586 |
$7K |
| 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) |
221 |
209 |
$7K |
| 99310 |
Prolong nursin fac eval 15m |
119 |
41 |
$7K |
| 82728 |
|
563 |
541 |
$7K |
| 0001A |
|
115 |
115 |
$7K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
325 |
255 |
$6K |
| 84466 |
|
585 |
556 |
$6K |
| 99000 |
|
5,233 |
4,623 |
$6K |
| 0154A |
|
79 |
78 |
$6K |
| 69210 |
|
135 |
124 |
$6K |
| 84153 |
|
386 |
363 |
$6K |
| 90750 |
|
97 |
92 |
$6K |
| 90682 |
|
203 |
148 |
$6K |
| 90674 |
|
810 |
765 |
$6K |
| 86140 |
|
1,220 |
1,153 |
$5K |
| 83540 |
|
916 |
877 |
$5K |
| 90707 |
|
780 |
646 |
$5K |
| 99309 |
Subsequent nursing facility care, per day, low to moderate complexity |
142 |
61 |
$5K |
| 81002 |
|
1,600 |
1,443 |
$5K |
| 0002A |
|
66 |
66 |
$5K |
| 90473 |
|
302 |
258 |
$4K |
| 0073A |
|
50 |
49 |
$4K |
| 90677 |
|
89 |
86 |
$4K |
| 0074A |
|
48 |
45 |
$3K |
| 85027 |
|
806 |
725 |
$3K |
| 87389 |
Infectious agent antigen detection by immunoassay technique, HIV-1 antigen with HIV-1 and HIV-2 antibodies |
124 |
118 |
$3K |
| 83655 |
|
279 |
229 |
$3K |
| 76642 |
|
43 |
39 |
$3K |
| 0081A |
|
32 |
32 |
$3K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
73 |
69 |
$3K |
| 85651 |
|
781 |
733 |
$3K |
| 0054A |
|
28 |
28 |
$2K |
| 0082A |
|
25 |
25 |
$2K |
| 0053A |
|
30 |
28 |
$2K |
| 99174 |
|
413 |
333 |
$2K |
| 87081 |
|
290 |
267 |
$2K |
| 90723 |
|
3,525 |
3,034 |
$2K |
| 0004A |
|
24 |
22 |
$2K |
| 90651 |
|
1,509 |
1,274 |
$2K |
| 96380 |
|
70 |
70 |
$1K |
| 90756 |
|
87 |
81 |
$1K |
| 84403 |
|
58 |
55 |
$1K |
| 87186 |
|
224 |
203 |
$1K |
| 93000 |
|
145 |
127 |
$1K |
| 57452 |
|
14 |
12 |
$1K |
| 76700 |
Ultrasound, abdominal, real time with image documentation; complete |
13 |
13 |
$1K |
| 87634 |
|
17 |
17 |
$1K |
| 85018 |
|
549 |
512 |
$1K |
| 76536 |
|
12 |
12 |
$1K |
| 90680 |
|
2,174 |
1,865 |
$1K |
| 99383 |
|
12 |
12 |
$1K |
| 94760 |
|
2,737 |
2,193 |
$1K |
| 85652 |
|
488 |
463 |
$967.95 |
| 90715 |
|
253 |
222 |
$880.96 |
| 81003 |
|
364 |
351 |
$823.02 |
| 90694 |
|
151 |
144 |
$796.55 |
| 86141 |
|
70 |
69 |
$741.06 |
| 90688 |
|
2,184 |
1,686 |
$692.08 |
| 90716 |
|
657 |
529 |
$635.61 |
| 99441 |
|
12 |
12 |
$560.59 |
| 90648 |
|
2,976 |
2,502 |
$542.14 |
| 90714 |
|
30 |
26 |
$540.41 |
| 86580 |
|
86 |
54 |
$525.31 |
| 86376 |
|
56 |
54 |
$517.05 |
| 82746 |
|
38 |
37 |
$489.83 |
| 77080 |
|
28 |
28 |
$458.17 |
| 94010 |
|
14 |
14 |
$437.64 |
| 84270 |
|
25 |
24 |
$414.47 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
48 |
41 |
$363.16 |
| 90661 |
|
91 |
91 |
$360.68 |
| 84480 |
|
67 |
58 |
$300.38 |
| J1094 |
Injection, dexamethasone acetate, 1 mg |
229 |
215 |
$291.45 |
| 73130 |
|
21 |
12 |
$261.63 |
| 73630 |
|
20 |
12 |
$237.68 |
| 87088 |
|
29 |
29 |
$233.74 |
| 96160 |
|
80 |
79 |
$229.11 |
| 83001 |
|
12 |
12 |
$227.15 |
| 86800 |
|
27 |
25 |
$211.61 |
| 82172 |
|
33 |
32 |
$211.33 |
| 90633 |
|
1,421 |
1,237 |
$200.91 |
| 90653 |
|
29 |
28 |
$199.30 |
| 82962 |
|
120 |
99 |
$175.52 |
| 87807 |
|
12 |
12 |
$161.73 |
| 90647 |
|
2,214 |
1,960 |
$155.23 |
| 94761 |
|
162 |
102 |
$144.38 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
248 |
230 |
$141.98 |
| 90474 |
|
19 |
15 |
$139.62 |
| 83735 |
|
30 |
27 |
$119.04 |
| 90662 |
|
35 |
30 |
$118.05 |
| 90734 |
|
694 |
591 |
$116.77 |
| 83695 |
|
25 |
25 |
$101.41 |
| 90672 |
|
681 |
517 |
$96.49 |
| 90681 |
|
218 |
196 |
$94.66 |
| G0328 |
Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous |
18 |
12 |
$93.72 |
| G0008 |
Administration of influenza virus vaccine |
573 |
527 |
$91.26 |
| 82274 |
|
14 |
12 |
$90.35 |
| 36416 |
|
511 |
414 |
$63.52 |
| 90685 |
|
463 |
353 |
$54.65 |
| 84100 |
|
12 |
12 |
$47.43 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
408 |
270 |
$36.16 |
| 90700 |
|
99 |
82 |
$5.30 |
| 91312 |
|
20 |
12 |
$0.03 |
| 91307 |
|
72 |
64 |
$0.01 |
| 90656 |
|
257 |
246 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
184 |
158 |
$0.00 |
| 90697 |
|
156 |
135 |
$0.00 |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
177 |
123 |
$0.00 |
| 90696 |
|
55 |
52 |
$0.00 |
| 90620 |
|
169 |
155 |
$0.00 |
| 99406 |
|
42 |
36 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
56 |
54 |
$0.00 |
| 91319 |
|
14 |
13 |
$0.00 |
| 90671 |
|
205 |
175 |
$0.00 |
| 90621 |
|
17 |
14 |
$0.00 |
| 91300 |
|
31 |
29 |
$0.00 |
| 90710 |
|
55 |
51 |
$0.00 |