| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
7,360 |
6,424 |
$282K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
654 |
647 |
$59K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
521 |
506 |
$51K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,305 |
1,791 |
$47K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
513 |
499 |
$44K |
| 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) |
804 |
772 |
$32K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
495 |
474 |
$25K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
201 |
200 |
$17K |
| 99429 |
|
343 |
334 |
$13K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
855 |
406 |
$12K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
1,305 |
1,112 |
$10K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
547 |
509 |
$8K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
145 |
139 |
$7K |
| 90461 |
|
404 |
347 |
$3K |
| 96160 |
|
908 |
887 |
$2K |
| 0071A |
|
37 |
37 |
$2K |
| 0072A |
|
31 |
31 |
$1K |
| 87999 |
|
422 |
405 |
$797.75 |
| 92551 |
|
1,872 |
1,841 |
$294.53 |
| 83655 |
|
14 |
14 |
$144.35 |
| 85018 |
|
15 |
15 |
$29.73 |
| 92587 |
|
26 |
26 |
$20.06 |
| 99174 |
|
875 |
870 |
$0.00 |
| 90723 |
|
67 |
67 |
$0.00 |
| 90686 |
|
392 |
391 |
$0.00 |
| 36416 |
|
63 |
63 |
$0.00 |
| 91307 |
|
81 |
69 |
$0.00 |
| 90651 |
|
41 |
37 |
$0.00 |
| 90680 |
|
63 |
63 |
$0.00 |
| 90656 |
|
12 |
12 |
$0.00 |
| 90633 |
|
14 |
14 |
$0.00 |
| 90670 |
|
91 |
91 |
$0.00 |
| 90648 |
|
179 |
178 |
$0.00 |
| 99173 |
|
1,500 |
1,485 |
$0.00 |
| 90671 |
|
69 |
68 |
$0.00 |
| 91300 |
|
34 |
30 |
$0.00 |
| 90715 |
|
14 |
14 |
$0.00 |
| 90734 |
|
51 |
51 |
$0.00 |