| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
11,580 |
10,346 |
$878K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
6,020 |
5,411 |
$566K |
| G0439 |
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit |
2,726 |
2,725 |
$293K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
7,871 |
7,771 |
$170K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,877 |
1,874 |
$146K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,641 |
1,638 |
$127K |
| G0438 |
Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit |
757 |
755 |
$110K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
812 |
812 |
$70K |
| 99401 |
|
2,090 |
2,040 |
$61K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
1,261 |
1,242 |
$53K |
| S0302 |
Completed early periodic screening diagnosis and treatment (epsdt) service (list in addition to code for appropriate evaluation and management service) |
6,455 |
6,429 |
$51K |
| 90461 |
|
1,988 |
1,976 |
$46K |
| 92551 |
|
4,128 |
4,124 |
$41K |
| 92567 |
|
2,531 |
2,525 |
$33K |
| 99058 |
|
3,000 |
2,733 |
$32K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
434 |
431 |
$32K |
| 99188 |
|
2,332 |
2,330 |
$31K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,805 |
3,789 |
$30K |
| 99051 |
|
4,152 |
4,014 |
$29K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
1,904 |
1,895 |
$27K |
| 36410 |
|
2,551 |
2,508 |
$25K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
1,656 |
1,604 |
$22K |
| G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
887 |
830 |
$10K |
| 94760 |
|
6,349 |
6,299 |
$8K |
| 99402 |
|
190 |
188 |
$8K |
| H0001 |
Alcohol and/or drug assessment |
256 |
255 |
$7K |
| 96127 |
|
1,010 |
1,007 |
$6K |
| 36415 |
Collection of venous blood by venipuncture |
1,925 |
1,900 |
$5K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
53 |
53 |
$5K |
| 81002 |
|
1,534 |
1,513 |
$4K |
| 99215 |
Prolong outpt/office vis |
27 |
27 |
$3K |
| 92015 |
Determination of refractive state |
238 |
238 |
$3K |
| 99173 |
|
1,952 |
1,948 |
$3K |
| 90686 |
|
3,727 |
3,721 |
$3K |
| 96160 |
|
1,266 |
1,266 |
$3K |
| 90716 |
|
397 |
395 |
$3K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
193 |
190 |
$2K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
109 |
106 |
$2K |
| 90707 |
|
314 |
314 |
$2K |
| 99495 |
|
12 |
12 |
$2K |
| 90651 |
|
170 |
169 |
$2K |
| 99000 |
|
2,839 |
2,770 |
$2K |
| 95004 |
Percutaneous tests with allergenic extracts, immediate type reaction |
14 |
14 |
$2K |
| A4208 |
Syringe with needle, sterile 3 cc, each |
4,765 |
4,666 |
$1K |
| 96161 |
|
270 |
266 |
$691.24 |
| A4930 |
Gloves, sterile, per pair |
3,772 |
3,675 |
$604.21 |
| 97802 |
|
32 |
32 |
$389.87 |
| 90715 |
|
75 |
74 |
$304.86 |
| 36406 |
|
25 |
25 |
$245.66 |
| 90620 |
|
174 |
174 |
$188.81 |
| 90734 |
|
86 |
85 |
$61.25 |
| 90633 |
|
101 |
100 |
$41.67 |
| 99070 |
|
85 |
81 |
$2.25 |
| 90648 |
|
372 |
370 |
$0.00 |
| 90700 |
|
197 |
196 |
$0.00 |
| 90671 |
|
144 |
143 |
$0.00 |
| 90685 |
|
47 |
47 |
$0.00 |
| 90670 |
|
232 |
231 |
$0.00 |
| 90713 |
|
25 |
25 |
$0.00 |
| G0310 |
Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 5 to 15 mins time (this code is used for medicaid billing purposes) |
36 |
36 |
$0.00 |
| 90723 |
|
145 |
144 |
$0.00 |
| 90744 |
|
68 |
68 |
$0.00 |