| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
54,623 |
46,049 |
$3.03M |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,166 |
2,159 |
$200K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
1,957 |
1,949 |
$197K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,378 |
3,070 |
$186K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
1,950 |
1,872 |
$168K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,388 |
1,377 |
$132K |
| T1015 |
Clinic visit/encounter, all-inclusive |
991 |
620 |
$74K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
1,193 |
1,136 |
$48K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,084 |
966 |
$43K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
2,720 |
2,675 |
$39K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
2,417 |
2,287 |
$35K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
665 |
592 |
$31K |
| 90688 |
|
1,821 |
1,811 |
$24K |
| 99385 |
|
142 |
142 |
$14K |
| 90670 |
|
732 |
729 |
$10K |
| 90686 |
|
571 |
569 |
$10K |
| 81003 |
|
4,824 |
4,669 |
$10K |
| 94760 |
|
9,388 |
8,545 |
$9K |
| 90680 |
|
561 |
557 |
$8K |
| G0511 |
Rural health clinic or federally qualified health center (rhc or fqhc) only, general care management, 20 minutes or more of clinical staff time for chronic care management services or behavioral health integration services directed by an rhc or fqhc practitioner (physician, np, pa, or cnm), per calendar month |
262 |
248 |
$8K |
| D0120 |
Periodic oral evaluation - established patient |
544 |
540 |
$8K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
923 |
903 |
$7K |
| 87428 |
|
433 |
425 |
$7K |
| 0011A |
|
186 |
186 |
$7K |
| 0012A |
|
181 |
181 |
$7K |
| D9999 |
Unspecified adjunctive procedure, by report |
532 |
529 |
$7K |
| D1206 |
Topical application of fluoride varnish |
357 |
355 |
$6K |
| 90697 |
|
312 |
305 |
$5K |
| 76816 |
Ultrasound, pregnant uterus, real time with image documentation, follow-up |
69 |
62 |
$5K |
| 99386 |
|
45 |
45 |
$5K |
| 0072A |
|
114 |
114 |
$5K |
| 76801 |
|
61 |
60 |
$4K |
| 0071A |
|
109 |
108 |
$4K |
| 0001A |
|
95 |
95 |
$4K |
| 0002A |
|
88 |
87 |
$4K |
| 90651 |
|
308 |
306 |
$3K |
| 83036 |
Hemoglobin; glycosylated (A1C) |
485 |
480 |
$3K |
| 90648 |
|
327 |
327 |
$3K |
| 90671 |
|
226 |
222 |
$3K |
| 92551 |
|
417 |
415 |
$3K |
| 0064A |
|
77 |
77 |
$3K |
| 90715 |
|
240 |
240 |
$3K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
332 |
290 |
$3K |
| 90723 |
|
258 |
258 |
$3K |
| 90734 |
|
183 |
181 |
$2K |
| 90633 |
|
91 |
89 |
$2K |
| 87807 |
|
111 |
109 |
$1K |
| 0004A |
|
30 |
30 |
$1K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
14 |
14 |
$1K |
| 76856 |
Ultrasound, pelvic (nonobstetric), real time with image documentation; complete |
19 |
17 |
$1K |
| 96161 |
|
395 |
379 |
$932.08 |
| 99499 |
|
41 |
41 |
$917.04 |
| 76805 |
Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation |
12 |
12 |
$897.42 |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
15 |
13 |
$781.96 |
| 90619 |
|
42 |
42 |
$626.13 |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
67 |
66 |
$488.31 |
| 81025 |
|
63 |
62 |
$442.14 |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
90 |
90 |
$418.14 |
| 90661 |
|
45 |
45 |
$394.57 |
| 85018 |
|
147 |
147 |
$315.07 |
| G2025 |
Payment for a telehealth distant site service furnished by a rural health clinic (rhc) or federally qualified health center (fqhc) only |
15 |
14 |
$315.03 |
| 90672 |
|
27 |
26 |
$289.55 |
| 90710 |
|
26 |
26 |
$284.52 |
| 82947 |
|
80 |
75 |
$274.35 |
| 90656 |
|
13 |
13 |
$258.99 |
| 83037 |
|
28 |
27 |
$229.09 |
| 90685 |
|
13 |
13 |
$210.23 |
| 90674 |
|
13 |
13 |
$209.96 |
| 99429 |
|
28 |
28 |
$193.06 |
| 36415 |
Collection of venous blood by venipuncture |
65 |
62 |
$157.21 |
| 90658 |
|
17 |
17 |
$131.19 |
| 81002 |
|
31 |
31 |
$91.76 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
51 |
51 |
$18.36 |
| J1050 |
Injection, medroxyprogesterone acetate, 1 mg |
39 |
38 |
$0.00 |
| 99072 |
|
93 |
88 |
$0.00 |