| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
9,888 |
7,739 |
$360K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
2,757 |
2,557 |
$107K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
931 |
925 |
$72K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
878 |
872 |
$71K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
4,475 |
2,085 |
$60K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,198 |
1,083 |
$59K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
671 |
656 |
$54K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
1,155 |
437 |
$53K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
4,936 |
2,471 |
$52K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
468 |
458 |
$35K |
| 99429 |
|
791 |
781 |
$25K |
| 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) |
359 |
356 |
$11K |
| 99253 |
|
83 |
79 |
$7K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
873 |
607 |
$7K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
532 |
497 |
$7K |
| 99254 |
|
57 |
54 |
$7K |
| 90461 |
|
854 |
734 |
$5K |
| 0072A |
|
89 |
88 |
$3K |
| 0071A |
|
78 |
77 |
$3K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
321 |
295 |
$2K |
| 99000 |
|
138 |
135 |
$1K |
| 99051 |
|
102 |
100 |
$1K |
| 87807 |
|
82 |
77 |
$882.20 |
| 0124A |
|
19 |
19 |
$760.00 |
| 0073A |
|
17 |
17 |
$680.00 |
| 0081A |
|
18 |
18 |
$680.00 |
| 96160 |
|
303 |
291 |
$586.25 |
| 0001A |
|
18 |
17 |
$520.00 |
| 92551 |
|
145 |
143 |
$472.23 |
| 83655 |
|
24 |
24 |
$244.08 |
| 81003 |
|
105 |
92 |
$178.42 |
| 90686 |
|
834 |
825 |
$0.07 |
| 90677 |
|
33 |
31 |
$0.03 |
| 90688 |
|
233 |
232 |
$0.02 |
| G0310 |
Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 5 to 15 mins time (this code is used for medicaid billing purposes) |
12 |
12 |
$0.00 |
| 90670 |
|
247 |
246 |
$0.00 |
| 99173 |
|
328 |
319 |
$0.00 |
| 90633 |
|
40 |
39 |
$0.00 |
| 91308 |
|
26 |
18 |
$0.00 |
| 90687 |
|
64 |
64 |
$0.00 |
| 91300 |
|
29 |
28 |
$0.00 |
| 91312 |
|
19 |
19 |
$0.00 |
| 90734 |
|
24 |
24 |
$0.00 |
| 90710 |
|
13 |
13 |
$0.00 |
| 96127 |
|
25 |
24 |
$0.00 |
| 90620 |
|
12 |
12 |
$0.00 |
| 90698 |
|
86 |
84 |
$0.00 |
| 91307 |
|
252 |
224 |
$0.00 |
| 90680 |
|
84 |
81 |
$0.00 |
| 90656 |
|
117 |
116 |
$0.00 |
| 90744 |
|
12 |
12 |
$0.00 |