| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,580 |
2,823 |
$128K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
3,658 |
2,838 |
$110K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
451 |
364 |
$22K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,882 |
795 |
$19K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
550 |
484 |
$17K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
415 |
340 |
$12K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
185 |
151 |
$11K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
903 |
697 |
$9K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
664 |
591 |
$6K |
| 99406 |
|
759 |
610 |
$3K |
| 36415 |
Collection of venous blood by venipuncture |
1,490 |
1,185 |
$2K |
| 96127 |
|
738 |
618 |
$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) |
90 |
79 |
$1K |
| 96160 |
|
80 |
64 |
$918.52 |
| 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) |
74 |
66 |
$828.00 |
| 86328 |
|
21 |
18 |
$805.39 |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
14 |
13 |
$780.49 |
| 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) |
740 |
425 |
$477.76 |
| 90661 |
|
25 |
20 |
$464.36 |
| 3077F |
|
1,939 |
1,440 |
$320.27 |
| 3080F |
|
1,251 |
977 |
$290.00 |
| 3079F |
|
1,728 |
1,354 |
$221.16 |
| 3074F |
|
3,175 |
2,474 |
$200.22 |
| 3078F |
|
3,121 |
2,416 |
$200.22 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
13 |
13 |
$160.67 |
| 3075F |
|
961 |
789 |
$140.83 |
| 85018 |
|
72 |
48 |
$112.67 |
| 81003 |
|
126 |
91 |
$112.49 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
140 |
120 |
$58.49 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
45 |
37 |
$47.88 |
| G0442 |
Annual alcohol misuse screening, 5 to 15 minutes |
39 |
21 |
$45.32 |
| G0444 |
Annual depression screening, 5 to 15 minutes |
43 |
25 |
$40.46 |
| 36416 |
|
21 |
15 |
$20.12 |
| 1125F |
|
3,528 |
2,585 |
$0.01 |
| 1126F |
|
2,804 |
2,277 |
$0.00 |
| 1101F |
|
43 |
31 |
$0.00 |
| 1034F |
|
1,853 |
1,435 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
24 |
15 |
$0.00 |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
58 |
44 |
$0.00 |
| 1170F |
|
43 |
25 |
$0.00 |
| 3008F |
|
63 |
40 |
$0.00 |
| 1124F |
|
46 |
32 |
$0.00 |
| 1159F |
|
61 |
39 |
$0.00 |