| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,753 |
9,352 |
$650K |
| 99199 |
Unlisted special service, procedure or report |
58,881 |
32,427 |
$372K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,310 |
2,023 |
$204K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
2,339 |
2,011 |
$109K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
730 |
621 |
$60K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
654 |
543 |
$57K |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
903 |
766 |
$45K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
490 |
417 |
$42K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,353 |
2,109 |
$29K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
199 |
179 |
$19K |
| 99401 |
|
641 |
579 |
$17K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
715 |
648 |
$13K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,726 |
1,225 |
$12K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
915 |
406 |
$11K |
| D0145 |
Oral evaluation for a patient under three years of age |
192 |
166 |
$7K |
| 92551 |
|
1,782 |
1,562 |
$5K |
| D1206 |
Topical application of fluoride varnish |
205 |
178 |
$3K |
| 99051 |
|
136 |
121 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
56 |
54 |
$2K |
| 96127 |
|
471 |
393 |
$2K |
| 90686 |
|
819 |
766 |
$2K |
| 99173 |
|
2,326 |
2,025 |
$2K |
| 96160 |
|
402 |
345 |
$1K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
32 |
31 |
$1K |
| 80061 |
Lipid panel |
46 |
38 |
$669.69 |
| 81002 |
|
485 |
416 |
$560.95 |
| 90734 |
|
26 |
24 |
$540.30 |
| 96161 |
|
150 |
139 |
$507.93 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
13 |
13 |
$495.69 |
| 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) |
16 |
16 |
$492.32 |
| 90670 |
|
306 |
244 |
$448.99 |
| 83655 |
|
26 |
25 |
$407.68 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
82 |
79 |
$407.17 |
| 85018 |
|
234 |
191 |
$279.91 |
| 90651 |
|
12 |
12 |
$257.98 |
| 85014 |
|
26 |
25 |
$30.70 |
| 99072 |
|
4,221 |
3,321 |
$2.90 |
| 99000 |
|
1,819 |
1,571 |
$0.00 |
| 36416 |
|
780 |
665 |
$0.00 |
| 90656 |
|
60 |
58 |
$0.00 |
| 90680 |
|
39 |
39 |
$0.00 |
| 90677 |
|
13 |
13 |
$0.00 |
| 90700 |
|
321 |
259 |
$0.00 |
| 90633 |
|
35 |
27 |
$0.00 |
| 90713 |
|
76 |
67 |
$0.00 |
| 90648 |
|
109 |
94 |
$0.00 |