| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
28,963 |
26,529 |
$2.82M |
| 99215 |
Prolong outpt/office vis |
3,714 |
3,617 |
$478K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,783 |
4,536 |
$352K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
9,018 |
8,995 |
$310K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
1,849 |
1,849 |
$164K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
1,748 |
1,747 |
$158K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
5,375 |
5,271 |
$142K |
| 87426 |
Infectious agent antigen detection, SARS-CoV-2 (COVID-19) |
3,436 |
3,362 |
$131K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
7,454 |
7,294 |
$105K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
813 |
812 |
$79K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
773 |
754 |
$65K |
| 96127 |
|
6,686 |
6,546 |
$31K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
3,238 |
3,233 |
$28K |
| 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) |
340 |
340 |
$11K |
| 92567 |
|
803 |
763 |
$10K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
51 |
51 |
$7K |
| 94010 |
|
212 |
203 |
$6K |
| 95117 |
|
365 |
140 |
$3K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
48 |
47 |
$2K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
50 |
37 |
$1K |
| 99188 |
|
67 |
67 |
$703.27 |
| 99441 |
|
13 |
12 |
$638.17 |
| 98966 |
|
27 |
27 |
$318.96 |
| 99051 |
|
47 |
47 |
$317.25 |
| 96161 |
|
38 |
37 |
$105.00 |
| 90686 |
|
2,839 |
2,839 |
$99.95 |
| J0696 |
Injection, ceftriaxone sodium, per 250 mg |
47 |
34 |
$91.98 |
| 96160 |
|
2,697 |
2,697 |
$4.52 |
| 90656 |
|
157 |
157 |
$0.20 |
| 90651 |
|
57 |
57 |
$0.01 |
| 90734 |
|
112 |
112 |
$0.01 |
| 90647 |
|
278 |
278 |
$0.00 |
| 90723 |
|
228 |
228 |
$0.00 |
| 90680 |
|
169 |
169 |
$0.00 |
| 90620 |
|
49 |
49 |
$0.00 |
| 90710 |
|
73 |
73 |
$0.00 |
| 90670 |
|
551 |
551 |
$0.00 |
| 90671 |
|
85 |
85 |
$0.00 |
| 90633 |
|
53 |
53 |
$0.00 |
| 90715 |
|
12 |
12 |
$0.00 |