| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
45,752 |
27,891 |
$1.02M |
| H0016 |
Alcohol and/or drug services; medical/somatic (medical intervention in ambulatory setting) |
4,418 |
2,596 |
$583K |
| H0033 |
Oral medication administration, direct observation |
2,387 |
1,129 |
$316K |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
10,614 |
8,944 |
$223K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
3,642 |
3,125 |
$219K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
4,578 |
3,368 |
$194K |
| G0483 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 22 or more drug class(es), including metabolite(s) if performed |
18,328 |
9,018 |
$153K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
3,192 |
2,506 |
$149K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
2,221 |
1,922 |
$135K |
| H0014 |
Alcohol and/or drug services; ambulatory detoxification |
793 |
358 |
$124K |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
3,941 |
3,005 |
$111K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
1,905 |
1,343 |
$86K |
| 80305 |
|
25,114 |
13,270 |
$75K |
| H0002 |
Behavioral health screening to determine eligibility for admission to treatment program |
12,769 |
5,823 |
$63K |
| 90853 |
Group psychotherapy (other than of a multiple-family group) |
9,390 |
5,772 |
$63K |
| 81025 |
|
14,499 |
6,901 |
$49K |
| 90832 |
Psychotherapy, 30 minutes with patient |
3,515 |
2,420 |
$46K |
| T1007 |
Alcohol and/or substance abuse services, treatment plan development and/or modification |
12,768 |
5,823 |
$45K |
| 99215 |
Prolong outpt/office vis |
728 |
569 |
$44K |
| 96372 |
Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular |
3,207 |
1,821 |
$32K |
| 99394 |
Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) |
414 |
358 |
$28K |
| 99381 |
|
546 |
366 |
$24K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
382 |
261 |
$23K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
759 |
656 |
$15K |
| H0049 |
Alcohol and/or drug screening |
5,490 |
2,546 |
$14K |
| 90791 |
Psychiatric diagnostic evaluation |
400 |
240 |
$13K |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
1,608 |
1,160 |
$12K |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
624 |
452 |
$10K |
| 36415 |
Collection of venous blood by venipuncture |
13,216 |
9,952 |
$9K |
| H0001 |
Alcohol and/or drug assessment |
519 |
319 |
$9K |
| 81002 |
|
13,369 |
6,713 |
$8K |
| 99384 |
|
66 |
62 |
$7K |
| H0038 |
Self-help/peer services, per 15 minutes |
1,712 |
929 |
$7K |
| 99408 |
|
847 |
505 |
$6K |
| 99211 |
Office or other outpatient visit for the evaluation and management of an established patient, minimal severity |
684 |
557 |
$5K |
| 82570 |
|
10,709 |
4,805 |
$5K |
| 99382 |
|
95 |
56 |
$4K |
| 81003 |
|
2,893 |
2,423 |
$4K |
| 99205 |
Prolong outpt/office vis |
57 |
40 |
$4K |
| 99395 |
Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years |
67 |
41 |
$4K |
| 99383 |
|
44 |
30 |
$2K |
| 99407 |
|
200 |
137 |
$2K |
| G0481 |
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms (any type, single or tandem and excluding immunoassays (e.g., ia, eia, elisa, emit, fpia) and enzymatic methods (e.g., alcohol dehydrogenase)), (2) stable isotope or other universally recognized internal standards in all samples (e.g., to control for matrix effects, interferences and variations in signal strength), and (3) method or drug-specific calibration and matrix-matched quality control material (e.g., to control for instrument variations and mass spectral drift); qualitative or quantitative, all sources, includes specimen validity testing, per day; 8-14 drug class(es), including metabolite(s) if performed |
273 |
128 |
$2K |
| 99173 |
|
347 |
323 |
$2K |
| 87811 |
Infectious agent antigen detection by immunoassay; SARS-CoV-2 (COVID-19) |
57 |
49 |
$2K |
| 80307 |
Drug test(s), presumptive, any number of drug classes; immunoassay |
164 |
131 |
$1K |
| 90686 |
|
305 |
263 |
$1K |
| 90673 |
|
97 |
75 |
$1K |
| G0447 |
Face-to-face behavioral counseling for obesity, 15 minutes |
125 |
94 |
$1K |
| 90670 |
|
676 |
511 |
$986.50 |
| G0049 |
With maintenance hemodialysis (in-center and home hd) for the complete reporting month |
25 |
14 |
$876.80 |
| G0312 |
Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service for ages under 21, 5 to 15 mins time (this code is used for medicaid billing purposes) |
68 |
66 |
$828.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
179 |
122 |
$787.42 |
| G0311 |
Immunization counseling by a physician or other qualified health care professional when the vaccine(s) is not administered on the same date of service, 16-30 mins time (this code is used for medicaid billing purposes) |
58 |
58 |
$699.00 |
| 94642 |
|
25 |
12 |
$411.85 |
| J1030 |
Injection, methylprednisolone acetate, 40 mg |
121 |
60 |
$396.30 |
| 90723 |
|
225 |
169 |
$326.08 |
| G0101 |
Cervical or vaginal cancer screening; pelvic and clinical breast examination |
21 |
12 |
$292.06 |
| 93000 |
|
16 |
12 |
$283.78 |
| 94760 |
|
432 |
319 |
$283.07 |
| 90707 |
|
94 |
77 |
$210.00 |
| 82962 |
|
281 |
191 |
$203.87 |
| 90716 |
|
41 |
31 |
$95.00 |
| 90633 |
|
170 |
133 |
$87.34 |
| 90648 |
|
569 |
437 |
$77.47 |
| 90658 |
|
34 |
25 |
$75.00 |
| 96127 |
|
19 |
14 |
$60.45 |
| J1100 |
Injection, dexamethasone sodium phosphate, 1 mg |
123 |
60 |
$15.26 |
| 99000 |
|
1,377 |
864 |
$0.00 |
| 90733 |
|
58 |
52 |
$0.00 |
| 90696 |
|
15 |
12 |
$0.00 |
| 99366 |
|
12 |
12 |
$0.00 |
| 90657 |
|
23 |
13 |
$0.00 |
| 90649 |
|
24 |
24 |
$0.00 |
| 90461 |
|
110 |
81 |
$0.00 |
| 90700 |
|
13 |
13 |
$0.00 |