| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
63,092 |
55,159 |
$2.25M |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
24,410 |
22,362 |
$1.22M |
| 87428 |
|
14,110 |
13,331 |
$976K |
| S8301 |
Infection control supplies, not otherwise specified |
36,793 |
31,923 |
$942K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
19,738 |
18,656 |
$781K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
5,716 |
5,596 |
$457K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
5,392 |
5,103 |
$433K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
5,571 |
5,423 |
$423K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
4,039 |
3,790 |
$300K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
26,064 |
12,229 |
$283K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
15,873 |
7,670 |
$215K |
| 85025 |
Blood count; complete (CBC), automated, and automated differential WBC count |
25,463 |
23,803 |
$162K |
| 87637 |
Infectious agent detection by nucleic acid; SARS-CoV-2, influenza, and RSV |
1,140 |
1,090 |
$147K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
10,498 |
10,189 |
$141K |
| 99429 |
|
4,204 |
4,128 |
$139K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
4,185 |
3,953 |
$102K |
| 99000 |
|
9,242 |
8,688 |
$92K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
6,418 |
5,320 |
$74K |
| 99050 |
|
4,956 |
4,742 |
$70K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
719 |
689 |
$57K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
1,173 |
1,115 |
$43K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
5,271 |
3,752 |
$42K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
717 |
697 |
$42K |
| 94010 |
|
1,619 |
1,604 |
$35K |
| 90461 |
|
6,310 |
5,191 |
$27K |
| 0001A |
|
676 |
664 |
$26K |
| 0002A |
|
598 |
597 |
$24K |
| 0071A |
|
495 |
470 |
$19K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
1,035 |
1,017 |
$14K |
| 0072A |
|
319 |
311 |
$12K |
| 96160 |
|
5,298 |
5,197 |
$11K |
| 81002 |
|
3,673 |
3,478 |
$10K |
| 97170 |
|
205 |
204 |
$9K |
| 99051 |
|
3,487 |
3,366 |
$8K |
| G8510 |
Screening for depression is documented as negative, a follow-up plan is not required |
759 |
741 |
$8K |
| 99215 |
Prolong outpt/office vis |
101 |
96 |
$8K |
| 86318 |
|
487 |
483 |
$8K |
| 90651 |
|
1,147 |
1,134 |
$7K |
| 90677 |
|
691 |
673 |
$5K |
| 92567 |
|
366 |
362 |
$5K |
| 0081A |
|
132 |
126 |
$5K |
| 0003A |
|
110 |
110 |
$4K |
| 86580 |
|
505 |
502 |
$4K |
| 90686 |
|
3,064 |
2,966 |
$4K |
| 0053A |
|
88 |
86 |
$3K |
| 90620 |
|
1,042 |
1,015 |
$3K |
| 86328 |
|
74 |
70 |
$3K |
| 87634 |
|
52 |
50 |
$3K |
| 94640 |
Pressurized or nonpressurized inhalation treatment for acute airway obstruction |
297 |
250 |
$3K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
28 |
28 |
$2K |
| 0073A |
|
30 |
30 |
$1K |
| 97169 |
|
47 |
45 |
$1K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
19 |
19 |
$923.68 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
2,429 |
2,301 |
$860.43 |
| 0082A |
|
19 |
19 |
$760.00 |
| 81007 |
|
29 |
29 |
$730.22 |
| 93000 |
|
60 |
60 |
$667.19 |
| 82016 |
|
52 |
51 |
$664.80 |
| 71046 |
Radiologic examination, chest; 2 views |
25 |
24 |
$660.38 |
| 82128 |
|
52 |
51 |
$559.20 |
| 69209 |
|
38 |
36 |
$432.27 |
| 96380 |
|
16 |
16 |
$305.44 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
2,190 |
2,140 |
$140.76 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
1,097 |
1,045 |
$99.80 |
| 84030 |
|
27 |
26 |
$92.40 |
| 90656 |
|
773 |
773 |
$87.35 |
| 90685 |
|
85 |
84 |
$42.00 |
| 90648 |
|
2,884 |
2,813 |
$0.00 |
| 90700 |
|
228 |
225 |
$0.00 |
| 90633 |
|
1,253 |
1,233 |
$0.00 |
| 90670 |
|
2,245 |
2,190 |
$0.00 |
| 91300 |
|
1,429 |
1,314 |
$0.00 |
| 90734 |
|
1,090 |
1,066 |
$0.00 |
| 90710 |
|
1,187 |
1,138 |
$0.00 |
| 90715 |
|
128 |
125 |
$0.00 |
| 90655 |
|
51 |
51 |
$0.00 |
| 90380 |
|
16 |
16 |
$0.00 |
| 91308 |
|
210 |
200 |
$0.00 |
| 90680 |
|
1,754 |
1,724 |
$0.00 |
| 90723 |
|
2,026 |
1,984 |
$0.00 |
| S3620 |
Newborn metabolic screening panel, includes test kit, postage and the laboratory tests specified by the state for inclusion in this panel (e.g., galactose; hemoglobin, electrophoresis; hydroxyprogesterone, 17-d; phenylalanine (pku); and thyroxine, total) |
69 |
68 |
$0.00 |
| 90696 |
|
228 |
217 |
$0.00 |
| 91307 |
|
1,049 |
934 |
$0.00 |
| 91305 |
|
212 |
206 |
$0.00 |
| 91301 |
|
17 |
15 |
$0.00 |