| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
238,153 |
214,415 |
$14.77M |
| 99199 |
Unlisted special service, procedure or report |
1,492,787 |
944,779 |
$8.56M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
70,468 |
62,497 |
$6.59M |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
88,061 |
75,159 |
$4.69M |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
48,006 |
42,369 |
$4.17M |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
44,989 |
40,973 |
$4.07M |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
32,647 |
29,914 |
$2.98M |
| 87428 |
|
28,559 |
24,141 |
$1.69M |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
16,984 |
15,254 |
$1.67M |
| 99401 |
|
44,017 |
37,660 |
$1.46M |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
28,221 |
27,829 |
$1.42M |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
48,013 |
47,311 |
$949K |
| D0145 |
Oral evaluation for a patient under three years of age |
26,122 |
24,076 |
$914K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
97,219 |
86,048 |
$907K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
23,592 |
19,676 |
$859K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
16,208 |
15,069 |
$587K |
| 99051 |
|
20,988 |
19,711 |
$521K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
55,840 |
50,699 |
$513K |
| D1206 |
Topical application of fluoride varnish |
26,175 |
24,064 |
$403K |
| 90834 |
Psychotherapy, 45 minutes with patient |
5,779 |
3,787 |
$395K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
21,528 |
9,744 |
$276K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
6,221 |
4,846 |
$240K |
| 90847 |
Family psychotherapy with the patient present, 50 minutes |
2,492 |
1,761 |
$215K |
| 99460 |
|
2,720 |
2,366 |
$200K |
| 83718 |
|
19,484 |
16,999 |
$186K |
| 99238 |
Hospital discharge day management, 30 minutes or less |
2,933 |
2,553 |
$175K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
12,603 |
11,817 |
$172K |
| 87807 |
|
10,523 |
8,877 |
$145K |
| 82465 |
|
26,747 |
24,027 |
$136K |
| 83655 |
|
9,364 |
8,883 |
$133K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
2,361 |
2,248 |
$98K |
| 96161 |
|
25,206 |
21,502 |
$90K |
| 92551 |
|
69,035 |
62,650 |
$90K |
| 96127 |
|
16,773 |
14,077 |
$72K |
| 90651 |
|
5,531 |
4,959 |
$69K |
| 99173 |
|
80,147 |
72,849 |
$47K |
| 87081 |
|
6,808 |
6,432 |
$47K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
4,623 |
3,864 |
$46K |
| 99462 |
|
1,370 |
1,114 |
$45K |
| 95117 |
|
4,270 |
3,398 |
$39K |
| 81003 |
|
21,813 |
19,899 |
$36K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
3,413 |
3,234 |
$36K |
| 90686 |
|
40,844 |
35,603 |
$33K |
| 92587 |
|
1,065 |
986 |
$29K |
| 90734 |
|
1,655 |
1,490 |
$27K |
| 0071A |
|
332 |
247 |
$16K |
| 90688 |
|
9,316 |
9,167 |
$14K |
| 99215 |
Prolong outpt/office vis |
103 |
82 |
$14K |
| 99381 |
|
133 |
130 |
$12K |
| 0072A |
|
248 |
156 |
$11K |
| 99239 |
Hospital discharge day management, more than 30 minutes |
111 |
102 |
$10K |
| 94664 |
|
917 |
890 |
$10K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
577 |
535 |
$9K |
| E0570 |
Nebulizer, with compressor |
63 |
63 |
$9K |
| 69210 |
|
259 |
224 |
$8K |
| 90480 |
|
151 |
148 |
$7K |
| 81001 |
|
1,731 |
1,632 |
$6K |
| 94760 |
|
8,425 |
7,421 |
$5K |
| 99232 |
Subsequent hospital care, per day, moderate complexity |
65 |
28 |
$4K |
| 99070 |
|
489 |
468 |
$4K |
| 90619 |
|
1,255 |
1,074 |
$3K |
| 0081A |
|
49 |
38 |
$3K |
| 90791 |
Psychiatric diagnostic evaluation |
25 |
25 |
$3K |
| 99222 |
Initial hospital care, per day, moderate complexity |
26 |
26 |
$3K |
| 90621 |
|
187 |
162 |
$3K |
| 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) |
97 |
97 |
$3K |
| 81025 |
|
366 |
329 |
$3K |
| 90670 |
|
28,788 |
25,414 |
$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) |
103 |
103 |
$2K |
| 82947 |
|
393 |
328 |
$2K |
| 99219 |
|
13 |
13 |
$2K |
| 90716 |
|
9,366 |
8,481 |
$1K |
| 90832 |
Psychotherapy, 30 minutes with patient |
34 |
28 |
$1K |
| 92552 |
|
56 |
56 |
$904.40 |
| 0082A |
|
12 |
12 |
$780.00 |
| 99217 |
|
12 |
12 |
$775.32 |
| 87086 |
Culture, bacterial; quantitative colony count, urine |
77 |
71 |
$746.25 |
| 90633 |
|
10,879 |
9,863 |
$719.92 |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
29 |
27 |
$582.68 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,118 |
1,055 |
$572.57 |
| 90713 |
|
32,365 |
29,240 |
$509.19 |
| 90715 |
|
204 |
181 |
$472.43 |
| 90707 |
|
8,677 |
7,761 |
$342.73 |
| 88720 |
|
51 |
35 |
$311.50 |
| 90700 |
|
43,848 |
39,497 |
$235.68 |
| 90656 |
|
3,662 |
3,621 |
$168.00 |
| 90744 |
|
9,717 |
8,693 |
$129.17 |
| 90680 |
|
18,894 |
16,927 |
$96.10 |
| 90647 |
|
20,667 |
18,608 |
$87.70 |
| A4620 |
Variable concentration mask |
33 |
31 |
$20.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
141 |
133 |
$13.37 |
| 90677 |
|
5,407 |
5,354 |
$5.55 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
139 |
117 |
$2.09 |
| 99499 |
|
2,006 |
1,798 |
$0.05 |
| 91321 |
|
56 |
56 |
$0.03 |
| 3074F |
|
309 |
285 |
$0.00 |
| 36416 |
|
775 |
755 |
$0.00 |
| 91307 |
|
773 |
539 |
$0.00 |
| 85018 |
|
25 |
25 |
$0.00 |
| J7512 |
Prednisone, immediate release or delayed release, oral, 1 mg |
18 |
18 |
$0.00 |
| 90687 |
|
3,149 |
3,085 |
$0.00 |
| 3078F |
|
208 |
191 |
$0.00 |
| J7510 |
Prednisolone oral, per 5 mg |
24 |
24 |
$0.00 |
| S0119 |
Ondansetron, oral, 4 mg (for circumstances falling under the medicare statute, use hcpcs q code) |
170 |
160 |
$0.00 |
| 91308 |
|
107 |
82 |
$0.00 |