| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
21,894 |
20,280 |
$1.12M |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
19,767 |
19,202 |
$991K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
7,572 |
7,030 |
$540K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
5,520 |
5,386 |
$367K |
| X5622 |
|
7,085 |
6,568 |
$326K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
5,475 |
4,930 |
$308K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
3,684 |
3,629 |
$244K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
15,547 |
14,999 |
$169K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
9,413 |
9,090 |
$132K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,110 |
1,086 |
$83K |
| 99188 |
|
8,537 |
8,318 |
$65K |
| 92551 |
|
8,759 |
8,537 |
$52K |
| T1013 |
Sign language or oral interpretive services, per 15 minutes |
945 |
674 |
$47K |
| 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 |
575 |
566 |
$46K |
| 96127 |
|
9,223 |
8,980 |
$31K |
| 99460 |
|
625 |
620 |
$31K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
2,949 |
2,665 |
$21K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
571 |
566 |
$21K |
| 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 |
526 |
518 |
$14K |
| 83655 |
|
1,312 |
1,284 |
$13K |
| 82306 |
Vitamin D; 25 hydroxy, includes fraction(s), if performed |
476 |
470 |
$13K |
| 99173 |
|
9,597 |
9,358 |
$11K |
| 36415 |
Collection of venous blood by venipuncture |
2,317 |
2,191 |
$10K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
997 |
964 |
$10K |
| 36416 |
|
2,998 |
2,733 |
$8K |
| 99000 |
|
457 |
446 |
$8K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
253 |
245 |
$6K |
| 99215 |
Prolong outpt/office vis |
76 |
67 |
$6K |
| 0071A |
|
134 |
130 |
$5K |
| 90686 |
|
6,169 |
5,985 |
$5K |
| 0072A |
|
112 |
109 |
$4K |
| 90473 |
|
404 |
396 |
$4K |
| 90480 |
|
183 |
182 |
$4K |
| 87081 |
|
706 |
682 |
$3K |
| 90691 |
|
27 |
27 |
$3K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
75 |
75 |
$3K |
| 0001A |
|
62 |
62 |
$2K |
| 96161 |
|
1,182 |
1,137 |
$2K |
| 0002A |
|
46 |
46 |
$2K |
| 99442 |
|
96 |
55 |
$2K |
| 85018 |
|
992 |
974 |
$2K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
188 |
184 |
$2K |
| 90474 |
|
417 |
407 |
$2K |
| 82728 |
|
78 |
78 |
$1K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
34 |
30 |
$805.63 |
| 99441 |
|
66 |
35 |
$798.50 |
| 90651 |
|
667 |
654 |
$671.89 |
| 0082A |
|
17 |
16 |
$652.01 |
| 80061 |
Lipid panel |
44 |
44 |
$579.61 |
| 0151A |
|
12 |
12 |
$485.88 |
| 84443 |
Thyroid stimulating hormone (TSH) |
25 |
24 |
$431.21 |
| 90656 |
|
487 |
484 |
$407.27 |
| 90461 |
|
14 |
14 |
$379.91 |
| 90670 |
|
3,572 |
3,454 |
$226.85 |
| 90734 |
|
486 |
480 |
$225.12 |
| 90710 |
|
92 |
92 |
$212.00 |
| 90744 |
|
1,525 |
1,485 |
$174.40 |
| 96381 |
|
12 |
12 |
$160.18 |
| 90633 |
|
1,499 |
1,466 |
$104.85 |
| 86140 |
|
15 |
14 |
$82.05 |
| 90696 |
|
346 |
346 |
$55.00 |
| 81001 |
|
57 |
49 |
$51.34 |
| 85652 |
|
14 |
12 |
$39.90 |
| 90648 |
|
337 |
328 |
$20.72 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
403 |
389 |
$9.57 |
| 90716 |
|
415 |
404 |
$0.01 |
| 91315 |
|
12 |
12 |
$0.01 |
| 90698 |
|
2,367 |
2,288 |
$0.00 |
| 90677 |
|
186 |
181 |
$0.00 |
| 90697 |
|
76 |
73 |
$0.00 |
| 90680 |
|
273 |
268 |
$0.00 |
| 91318 |
|
16 |
16 |
$0.00 |
| 90681 |
|
937 |
909 |
$0.00 |
| 90700 |
|
253 |
246 |
$0.00 |
| 90707 |
|
425 |
417 |
$0.00 |
| 90685 |
|
668 |
639 |
$0.00 |
| 90715 |
|
170 |
170 |
$0.00 |
| 99421 |
|
13 |
13 |
$0.00 |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
46 |
42 |
$0.00 |
| 90672 |
|
24 |
24 |
$0.00 |