| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
31,250 |
27,982 |
$2.01M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
9,148 |
8,333 |
$862K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
17,936 |
16,957 |
$743K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
7,077 |
6,814 |
$643K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
6,559 |
6,270 |
$590K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
6,749 |
6,209 |
$562K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
2,065 |
1,939 |
$287K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
16,876 |
15,441 |
$282K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
2,710 |
2,492 |
$257K |
| 87651 |
Infectious agent detection by nucleic acid; Streptococcus, group A, amplified probe |
3,079 |
2,845 |
$102K |
| 94760 |
|
38,490 |
33,891 |
$92K |
| 99173 |
|
10,412 |
9,831 |
$81K |
| 99215 |
Prolong outpt/office vis |
408 |
369 |
$53K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
5,076 |
4,636 |
$52K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,998 |
2,853 |
$44K |
| 99174 |
|
3,374 |
3,219 |
$42K |
| 96127 |
|
2,345 |
2,214 |
$35K |
| 90670 |
|
4,428 |
4,216 |
$32K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
1,739 |
1,641 |
$31K |
| 83655 |
|
2,221 |
2,115 |
$28K |
| 90651 |
|
1,501 |
1,391 |
$28K |
| 90791 |
Psychiatric diagnostic evaluation |
150 |
148 |
$23K |
| 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) |
734 |
691 |
$23K |
| 90480 |
|
458 |
433 |
$21K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
470 |
442 |
$19K |
| 0071A |
|
381 |
283 |
$17K |
| 90710 |
|
809 |
763 |
$15K |
| 0072A |
|
274 |
245 |
$15K |
| 99000 |
|
9,249 |
8,360 |
$12K |
| 90723 |
|
3,843 |
3,621 |
$11K |
| 99383 |
|
108 |
103 |
$10K |
| 90686 |
|
7,390 |
6,942 |
$9K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
311 |
295 |
$9K |
| 90461 |
|
9,633 |
9,176 |
$9K |
| 36416 |
|
6,200 |
5,662 |
$9K |
| 90734 |
|
915 |
852 |
$8K |
| 90680 |
|
2,432 |
2,237 |
$8K |
| 90832 |
Psychotherapy, 30 minutes with patient |
141 |
100 |
$7K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
488 |
452 |
$7K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
140 |
129 |
$6K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
53 |
52 |
$5K |
| 90837 |
Psychotherapy, 53 minutes with patient |
80 |
25 |
$5K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
30 |
30 |
$4K |
| 90633 |
|
2,292 |
2,190 |
$4K |
| 90647 |
|
4,040 |
3,814 |
$4K |
| 36415 |
Collection of venous blood by venipuncture |
1,161 |
1,061 |
$3K |
| 90716 |
|
155 |
147 |
$3K |
| 90696 |
|
595 |
560 |
$2K |
| 85018 |
|
825 |
791 |
$2K |
| 91321 |
|
138 |
138 |
$2K |
| 90671 |
|
503 |
473 |
$2K |
| 0074A |
|
29 |
29 |
$2K |
| 90715 |
|
513 |
485 |
$2K |
| 0054A |
|
28 |
27 |
$2K |
| 81002 |
|
483 |
451 |
$2K |
| 0001A |
|
58 |
44 |
$1K |
| 90681 |
|
393 |
390 |
$1K |
| G8431 |
Screening for depression is documented as being positive and a follow-up plan is documented |
42 |
39 |
$1K |
| 96380 |
|
72 |
64 |
$1K |
| 90656 |
|
683 |
668 |
$1K |
| 90677 |
|
338 |
312 |
$1K |
| 99382 |
|
12 |
12 |
$1K |
| 0154A |
|
18 |
18 |
$1K |
| 0124A |
|
17 |
17 |
$1K |
| 90707 |
|
274 |
272 |
$823.84 |
| 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) |
19 |
19 |
$605.16 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
45 |
36 |
$592.14 |
| 90700 |
|
320 |
308 |
$487.71 |
| 94761 |
|
114 |
108 |
$373.20 |
| 91322 |
|
25 |
21 |
$265.00 |
| 90620 |
|
84 |
82 |
$253.44 |
| 91318 |
|
55 |
49 |
$248.00 |
| 91319 |
|
67 |
61 |
$200.00 |
| 94664 |
|
14 |
13 |
$174.46 |
| 90672 |
|
91 |
69 |
$110.91 |
| 99072 |
|
1,233 |
783 |
$70.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
148 |
139 |
$9.52 |
| 96160 |
|
46 |
36 |
$9.12 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
17 |
12 |
$2.16 |
| 91300 |
|
187 |
113 |
$0.00 |
| 91320 |
|
14 |
13 |
$0.00 |
| 91308 |
|
35 |
27 |
$0.00 |
| 90685 |
|
12 |
12 |
$0.00 |
| 86328 |
|
32 |
13 |
$0.00 |
| 90380 |
|
16 |
12 |
$0.00 |
| 91312 |
|
17 |
17 |
$0.00 |
| 91307 |
|
842 |
676 |
$0.00 |
| 91305 |
|
60 |
57 |
$0.00 |
| 91315 |
|
18 |
18 |
$0.00 |
| 90660 |
|
14 |
14 |
$0.00 |